Subthreshold nanosecond laser shows no benefit for intermediate AMD

Investigators evaluated the safety and efficacy of subthreshold nanosecond laser (SNL) treatment in patients with intermediate AMD.

Study design

This 36-month, multicenter, double-masked, randomized, sham-controlled trial comprised 292 patients with intermediate AMD who had bilateral large drusen without any signs of late AMD on multimodal imaging. Participants were randomized to receive either retinal rejuvenation therapy SNL (2RT; Ellex) or sham treatment in the study eye at 6-month intervals.

Outcomes

After 36 months, SNL therapy did not slow the progression of intermediate AMD. However, a post hoc analysis showed that SNL appeared to slow disease progression in the subgroup of patients without reticular pseudodrusen (RPD) and accelerate progression in the subgroup with RPD.

Limitations

Even though subgroup analysis showed that laser might delay progression of AMD in some patients (i.e., those without RPD), we need to bear in mind that a retrospective subgroup analysis of a prospective trial results in the loss of baseline randomization. Hence, the results must be interpreted with caution. Physicians should be wary of false advertising; the Ellex website claims its product can slow AMD progression.

Clinical significance

These results show that laser is not beneficial and should not be performed for intermediate AMD at this time.