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L-DOPA may delay progression of non-neovascular AMD to neovascular AMD
L-DOPA may delay progression of non-neovascular AMD to neovascular AMD suggests a new study published in the Ophthalmology Retina.
Design
Three studies were performed: retrospective analyses in the Vestrum Health Retina Database (#1–2) and case-control analysis in the Merative MarketScan Research Databases (#3).
Eyes with neovascular AMD and 2 years of follow-up (#1). Eyes with non-neovascular AMD and 1 to 5 years of follow-up (#2). Patients aged ≥ 55 years with newly diagnosed neovascular AMD matched to controls without neovascular AMD (#3).
Eyes were divided into 2 groups (#1–2): exposed to L-DOPA before or on the date of neovascular (#1) or nonneovascular (#2) AMD diagnosis, and eyes not exposed to L-DOPA. We extracted AMD risk factors, number of intravitreal injections (#1), and conversion rate to neovascular AMD (#2). We calculated the percentage of newly diagnosed neovascular AMD cases and matched controls exposed to any L-DOPA and determined the cumulative 2-year dose in grams by tertiles (< 100 mg, approximately 100–300 mg, and approximately > 300 mg per day, #3).
Results
In the Vestrum database, eyes with neovascular AMD that were exposed to L-DOPA underwent 1 fewer intravitreal injection over 2 years (N = 84 088 control vs. 530 L-DOPA eyes, P = 0.006). In eyes with nonneovascular AMD (N = 42 081–203 155 control vs. 314–1525 L-DOPA eyes), L-DOPA exposure was associated with a reduced risk of conversion to neovascular AMD by 21% at year 2 (P = 0.029), 35% at years 3 to 4 (P < 0.001), and 28% at year 5 (P = 0.024). In the MarketScan databases (N = 86 900 per group), cumulative 2-year doses of L-DOPA between approximately 100 to 300 mg per day and approximately > 300 mg were associated with decreased odds of developing neovascular AMD by 15% (odds ratio [OR], 0.85; 95% confidence interval [CI], 0.75–0.97) and 23% (OR, 0.77; 95% CI, 0.67–0.87), respectively.
The researchers concluded that Levodopa use was associated with reduced detection of new-onset neovascular AMD. However a prospective, randomized clinical trial should be considered to investigate whether low-dose L-DOPA reduces neovascular AMD conversion.
Reference:
Max J. Hyman, Dimitra Skondra, Nitika Aggarwal, John Moir, Nick Boucher, Brian S. McKay, Mathew W. MacCumber, Jeremy A. Lavine. Levodopa Is Associated with Reduced Development of Neovascular Age-Related Macular Degeneration. Ophthalmology Retina, Volume 7, Issue 9, 2023, Pages 745-752, ISSN 2468-6530,
https://doi.org/10.1016/j.oret.2023.04.014.
(https://www.sciencedirect.com/science/article/pii/S2468653023001987)
Keywords:
L-DOPA, may, delay, progression, non-neovascular, AMD, neovascular, Ophthalmology Retina, Age-related macular degeneration; Levodopa; Neovascular age-related macular degeneration; Parkinson's disease, Max J. Hyman, Dimitra Skondra, Nitika Aggarwal, John Moir, Nick Boucher, Brian S. McKay, Mathew W. MacCumber, Jeremy A. Lavine
Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751