Real World Data Comparison of Standard Care vs SDM Laser Vision Protection Therapy for Prevention of Neovascular AMD

PURPOSE: To access the impact of regular periodic subthreshold diode micropulse laser (SDM) as Vision Protection Therapy on the rate of neovascular conversion of dry age-related macular degeneration (AMD). METHODS: Patient unidentified clinical data aggregated by Vestrum Health, LLC (VH) from 300 retina specialists across the United States was analyzed to examine the effect of a program of regular periodic panmacular low-intensity/high-density subthreshold diode micropulse laser as vision protection therapy (VPT) compared to standard care alone, on the incidence of neovascular conversion in patients with dry age-related macular degeneration (AMD), between January 4, 2016, and September 30, 2020, producing 392,250 eyes for study. RESULTS: After applying inclusion and exclusion criteria, eyes were matched by propensity scoring for key risk factors. This produced 830 eyes managed by standard care plus VPT, performed on average every 108 days per eye; and 8300 eyes managed with standard care alone (SCA) in a 1/10 ratio for comparison. Comparison found that VPT eyes had a markedly lower rate of neovascular conversion than SCA eyes (hazard ratio 13.04) overall, and for each propensity score matched quintile. VA worsened over time in the SCA group but improved in the VPT group. CONCLUSION: Our findings suggest that, compared to standard care alone, VPT may markedly reduce the rate of neovascular conversion in AMD, the main cause of irreversible visual loss worldwide.