by: Pam Harrison
A type of laser known as subthreshold diode micropulse laser (SDM) therapy restores sensitivity to inhibitors of vascular endothelial growth factor (VEGF) for treatment in patients with neovascular age-related macular degeneration (AMD) whose eyes no longer respond to treatment, new research shows.
“SDM is simple and exceedingly safe. It has no known side effects or adverse treatment effects, provided it is done correctly, and anyone can do it with appropriate existing equipment,” lead author Jeffrey K. Luttrull, MD, from Diseases and Surgery of the Macula, Retina, and Vitreous, Retina Diagnostic Laboratory of Ventura County, Ventura, California, told Medscape Medical News.
“And the discovery that SDM works without laser-induced retinal damage gives us important new insights into retinal physiology and will create new opportunities for therapeutic and preventative treatments.”
The study was published in the June issue of Retina.
Researchers performed SDM laser treatment in a total of 13 eyes in 12 patients between 73 and 97 years of age (average age, 84 years).
Patients had developed drug tolerance to anti-VEGF treatment, including at least three consecutive ineffective aflibercept injections, after receiving an average of 34 anti-VEGF injections (range, 16 – 67 injections), typically given on a near-monthly basis.
Once diagnosed with drug intolerance, patients were treated with a single session of SDM administered 1 month after the final clinically ineffective aflibercept injection. Aflibercept was resumed 1 month later.
After SDM treatment and resumption of aflibercept, 92% (12 of 13) of eyes improved, with complete resolution of macular exudation in 69% (9 of 13 eyes), Dr Luttrull and colleagues report.
“Even eyes that did not completely respond had only trace amounts of residual exudation, as is normally observed in drug-sensitive patients,” Dr Luttrull observed.
The one eye that did not respond at all to the SDM session had retinal pigment epithelium (RPE) atrophy. As Dr Luttrull explained, in this eye, there was nothing to absorb the laser, and if there is no absorption target, the laser can have no effect……..
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Source: Medscape