Intraocular Lenses with Blue-Light Filter Lowers Macular Atrophy Progression in nAMD Patients: Study

A recent study published in the American Journal of Ophthalmology examined blue-light filtering (BLF) intraocular lenses (IOLs) and their impact on the development and progression of macular atrophy (MA) among the patients with neovascular age-related macular degeneration (nAMD). This retrospective cohort study was conducted in the period from 2007 to 2018 with follow-up until June 2023 and revealed significant insights into the effectiveness of BLF IOLs during cataract surgery in nAMD patients.

The study involved 373 eyes from a total of 373 patients who underwent uneventful cataract surgery to determine whether BLF IOLs could offer benefits over non-BLF IOLs in preventing the onset or slowing the progression of MA. The participants with an average age of 78.6 years at the time of surgery and predominantly female (67.4%) were divided into two groups based on the type of IOL received; 206 received BLF IOLs and 167 received non-BLF IOLs.

The patients were treated with anti-vascular endothelial growth factor (VEGF) injections as part of their nAMD management. This study carefully reviewed all optical coherence tomography (OCT) scans manually by ensuring a blind assessment concerning baseline variables and the type of IOL implanted. These scans were utilized to measure and calculate the area of MA using Heidelberg software.

The results from the extensive follow-up (mean follow-up times were comparable between the two groups) showed that the incidence of new-onset MA and its distribution were similar between the BLF and non-BLF IOL groups that indicated no significant advantage of BLF IOLs in preventing new MA cases. But, the progression of existing MA measured over time suggested a different trend. The initial benefit in MA-free survival was not obvious, yet, the patients with BLF IOLs demonstrated a slower progression of macular atrophy when compared to the individuals with non-BLF IOLs.

Also, the final area of MA at the last visit showed a significant difference in patients with BLF IOLs had smaller areas of MA (5.14±4.71mm²) when compared to the individuals with non-BLF IOLs (8.56±9.17mm²). The mean annual increase in MA area was lower in the BLF IOL group (0.78±0.84mm² per year) versus the non-BLF IOL group (1.26±1.32mm² per year) that further supported that BLF IOLs could moderate the progression of macular degeneration. These findings suggest that while BLF IOLs may not prevent the initial development of macular atrophy in patients with nAMD, this could be beneficial in slowing the deterioration of the condition over time.

Reference:

Achiron, A., Trivizki, O., Knyazer, B., Elbaz, U., Hecht, I., Jeon, S., Kanclerz, P., & Tuuminen, R. (2024). The effect of blue-light filtering intraocular lenses on the development and progression of macular atrophy in eyes with nAMD. In American Journal of Ophthalmology. Elsevier BV. https://doi.org/10.1016/j.ajo.2024.04.018