Abstract
PurposeTo investigate changes in retinal thickness, drusen volume, and visual acuity following subthreshold nanosecond laser (SNL) treatment in patients with age-related macular degeneration (ARMD).DesignRetrospective chart review.MethodsPatients with intermediate ARMD treated with a single session of SNL (2RT®, Ellex R&D Pty Ltd, Adelaide, Australia) were included. Swept-source optical coherence tomography (OCT) imaging (Triton; Topcon Medical Systems, Tokyo, Japan) was performed within 6 months before and after SNL treatment. Retinal layers were segmented using the artificial intelligence-enabled Orion® software (Voxeleron LLC, San Francisco, USA). The macular region was analyzed according to the Early Treatment Diabetic Retinopathy Study map. Mean difference and standard deviation in baseline and post-treatment retinal layer thicknesses are reported.Results37 eyes from 25 patients were included in this study (mean age 74.7±9.2 years). An average of 51±6 spots were applied around the macula of each study eye, with a mean spot power of 0.33±0.04mJ. Increases in total retinal thickness were observed within the outer temporal and inferior sectors (P<0.05). Within the annulus, there was an increase in thickness of the sub-retinal pigment epithelial (RPE) space [0.88±2.41μm, P = 0.03], defined between the RPE and Bruch’s membrane. An increase in thickness of 1.13±2.55μm (P = 0.01) was also noted in the inferior sector of the photoreceptor complex, defined from the inner and outer segment junction to the RPE. Decreases in thickness were observed within the superior sector of the inner nuclear layer (INL) [-1.08±2.55μm, P = 0.01], and within the annulus of the outer nuclear layer (ONL) [-1.44±3.55μm, P = 0.02].ConclusionsAt 6 months post-SNL treatment, there were sectoral increases in OPL, photoreceptor complex, and sub-RPE space thicknesses and sectoral decreases in INL and ONL thicknesses. This pilot study demonstrates the utility of OCT combined with artificial intelligence-enabled software to track retinal changes that occur following SNL treatment in intermediate ARMD.
Highlights
Age-Related Macular Degeneration (ARMD) affects between 7.4–30% of those aged 45 to 85, and is a common cause of blindness [1]
At 6 months post-subthreshold nanosecond laser (SNL) treatment, there were sectoral increases in OPL, photoreceptor complex, and sub-retinal pigment epithelium (RPE) space thicknesses and sectoral decreases in inner nuclear layer (INL) and outer nuclear layer (ONL) thicknesses. This pilot study demonstrates the utility of optical coherence tomography (OCT) combined with artificial intelligence-enabled software to track retinal changes that occur following SNL treatment in intermediate ARMD
This leads to the accumulation of lipid-rich extracellular material between the retinal pigment epithelium (RPE) and Bruch’s membrane (BM), which are seen on fundus examination as drusen
Summary
Age-Related Macular Degeneration (ARMD) affects between 7.4–30% of those aged 45 to 85, and is a common cause of blindness [1]. ARMD is characterized by a thickened Bruch’s membrane (BM), which results from a deterioration in its transport functions. This leads to the accumulation of lipid-rich extracellular material between the retinal pigment epithelium (RPE) and BM, which are seen on fundus examination as drusen. Subthreshold nanosecond laser (SNL) was investigated as a potential treatment for decreasing ARMD progression. The Laser Intervention in Early Stages of Age-Related Macular Degeneration (LEAD) study was the first multi-centered randomized controlled trial to investigate the impact of SNL treatment in patients with intermediate ARMD. This study found that SNL treatment did not reduce the overall rate of progression to late ARMD. Further study is required to definitively delineate this relationship, given the limitations of this retrospective analysis, including the loss of randomization [8,9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
