Laser photocoagulation as treatment of non-exudative age-related macular degeneration: state-of-the-art and future perspectives

Graefes Arch Clin Exp Ophthalmol. 2018 Jan;256(1):1-9. doi: 10.1007/s00417-017-3848-x. Epub 2017 Nov 25.

Abstract

Purpose: To give an updated review of laser approaches to non-exudative age-related macular degeneration (AMD).

Methods: PubMed and Medline database searches were carried out using the terms "laser" and "photocoagulation" associated with "age-related macular degeneration", and latest publications up to May 2017 have been reviewed. Moreover, the design of an ongoing single-center, non-randomized, phase I-II, pilot study, the PASCAL-GA trial, coordinated by F. Bandello, MD and G. Querques, MD from the IRCCS Ospedale San Raffaele, is described.

Results: Either standard or subthreshold laser strategies have been tried to induce regression of distinct phenotypes of AMD, as reticular pseudodrusen (RPD), nascent geographic atrophy (nGA), and drusen-associated geographic atrophy (DAGA), with heterogeneous results. The aim of the PASCAL-GA protocol is to assess if subthreshold laser can restore the retinal pigment epithelium function in eyes with RPD and nGA offering a protective effect against extensive GA.

Conclusions: New-generation medical and surgical approaches, including subthreshold laser photocoagulation, may have some success in downstaging AMD.

Keywords: Age-related macular degeneration; Laser photocoagulation; Reticular pseudodrusen; Subthreshold laser.

Publication types

  • Review

MeSH terms

  • Humans
  • Laser Coagulation / methods*
  • Pilot Projects
  • Visual Acuity*
  • Wet Macular Degeneration / surgery*