Giuseppe Querques1, Maria Vittoria Cicinelli2, Alessandro Rabiolo2, Luigi de Vitis2, Riccardo Sacconi2,3, Lea Querques2, Francesco Bandello2. 1. Department of Ophthalmology, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy. giuseppe.querques@hotmail.it. 2. Department of Ophthalmology, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy. 3. Department of Ophthalmology, University of Verona, University hospital of Verona, Verona, Italy.
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.
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.
Authors: Eric M Moult; Nadia K Waheed; Eduardo A Novais; WooJhon Choi; ByungKun Lee; Stefan B Ploner; Emily D Cole; Ricardo N Louzada; Chen D Lu; Philip J Rosenfeld; Jay S Duker; James G Fujimoto Journal: Retina Date: 2016-12 Impact factor: 4.256