Nanosecond laser therapy reverses pathologic and molecular changes in age-related macular degeneration without retinal damage.
Age-related macular degeneration (AMD) is a leading cause of vision loss, characterized by drusen deposits and thickened Bruch's membrane (BM). This study details the capacity of nanosecond laser treatment to reduce drusen and thin BM while maintaining retinal structure. Fifty patients with AMD had a single nanosecond laser treatment session and after 2 yr, change in drusen area was compared with an untreated cohort of patients. The retinal effect of the laser was determined in human and mouse eyes using immunohistochemistry and compared with untreated eyes. In a mouse with thickened BM (ApoEnull), the effect of laser treatment was quantified using electron microscopy and quantitative PCR. In patients with AMD, nanosecond laser treatment reduced drusen load at 2 yr. Retinal structure was not compromised in human and mouse retina after laser treatment, with only a discrete retinal pigment epithelium (RPE) injury, and limited mononuclear cell response observed. BM was thinned in the ApoEnull mouse 3 mo after treatment (ApoEnull treated 683 ± 38 nm, ApoEnull untreated 890 ± 60 nm, C57Bl6J 606 ± 43 nm), with the expression of matrix metalloproteinase-2 and -3 increased (>260%). Nanosecond laser resolved drusen independent of retinal damage and improved BM structure, suggesting this treatment has the potential to reduce AMD progression.
Department of Anatomy and Neuroscience, The University of Melbourne, Victoria, Australia;
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AI
Jobling
Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia; and.
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RH
Guymer
Department of Anatomy and Neuroscience, The University of Melbourne, Victoria, Australia;
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KA
Vessey
Department of Anatomy and Neuroscience, The University of Melbourne, Victoria, Australia;
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Greferath
Department of Anatomy and Neuroscience, The University of Melbourne, Victoria, Australia;
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SA
Mills
Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia; and.
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KH
Brassington
Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia; and.
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Luu
Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia; and.
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KZ
Aung
Department of Anatomy and Neuroscience, The University of Melbourne, Victoria, Australia;
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Trogrlic
Ellex R&D Pty Ltd, Adelaide, Australia.
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M
Plunkett
Department of Anatomy and Neuroscience, The University of Melbourne, Victoria, Australia; elf@unimelb.edu.au.
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Fletcher
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000818:Animals; D016570:Bruch Membrane / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053685:Laser Therapy; D008268:Macular Degeneration / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D020782:Matrix Metalloproteinases / Q000378:metabolism; D051379:Mice; D008810:Mice, Inbred C57BL; D008875:Middle Aged; D010865:Pilot Projects; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012160:Retina / Q000503:physiopathology*; D012164:Retinal Diseases / Q000503:physiopathology / Q000628:therapy*; D055213:Retinal Pigment Epithelium / Q000473:pathology
D020782:Matrix Metalloproteinases
Bruch’s membrane; drusen; matrix metalloproteinase; vision loss