Levodopa is associated with reduced development of new-onset geographic atrophy in patients with age-related macular degeneration

Abstract Background Geographic atrophy (GA) is a significant cause of vision loss in patients with age-related macular degeneration (AMD). Current treatments are limited to anti-complement drugs, which have limited efficacy to delay progression with significant risk of complications. Levodopa (L-DOP...

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Main Authors: Kyle S. Chan, Nitika Aggarwal, Shannon Lawson, Nick Boucher, Mathew W. MacCumber, Jeremy A. Lavine
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Eye and Vision
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Online Access:https://doi.org/10.1186/s40662-024-00412-2
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author Kyle S. Chan
Nitika Aggarwal
Shannon Lawson
Nick Boucher
Mathew W. MacCumber
Jeremy A. Lavine
author_facet Kyle S. Chan
Nitika Aggarwal
Shannon Lawson
Nick Boucher
Mathew W. MacCumber
Jeremy A. Lavine
author_sort Kyle S. Chan
collection DOAJ
description Abstract Background Geographic atrophy (GA) is a significant cause of vision loss in patients with age-related macular degeneration (AMD). Current treatments are limited to anti-complement drugs, which have limited efficacy to delay progression with significant risk of complications. Levodopa (L-DOPA) is a byproduct of melanin synthesis that is associated with reduced development of neovascular AMD. In this study, we determined if L-DOPA was associated with a reduced likelihood of new-onset GA. Methods We performed a retrospective analysis in the Vestrum Health Retina Database. We included eyes with non-neovascular AMD without GA and 1–5 years of follow-up. Eyes were divided into two groups. Exposed to L-DOPA before or on the date of non-neovascular AMD without GA diagnosis, and eyes not exposed to L-DOPA. We extracted age, sex, AREDS2 status, dry AMD stage, smoking history, and conversion rate to GA at years 1 through 5. Propensity score matching was used to match L-DOPA and control groups. Cox proportional hazard regression, adjusting for age, sex, AMD severity, AREDS2 use, smoking status, and L-DOPA use was employed to calculate hazard ratios for new-onset GA detection. Results We identified 112,089 control and 844 L-DOPA exposed eyes with non-neovascular AMD without GA. After propensity score matching, 2532 control and 844 L-DOPA exposed eyes remained that were well-matched for age, sex, AMD severity, AREDS2 use, and smoking status. We found that L-DOPA exposure was associated with a significantly reduced likelihood (HR = 0.68, 95% CI: 0.48–0.95, P = 0.025) of new-onset GA detection. Conclusion L-DOPA use was associated with reduced detection of new-onset GA.
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spelling doaj-art-ea4b171ff11e49d490f7343f69eef9cb2024-11-10T12:08:17ZengBMCEye and Vision2326-02542024-11-011111610.1186/s40662-024-00412-2Levodopa is associated with reduced development of new-onset geographic atrophy in patients with age-related macular degenerationKyle S. Chan0Nitika Aggarwal1Shannon Lawson2Nick Boucher3Mathew W. MacCumber4Jeremy A. Lavine5Department of Ophthalmology, Feinberg School of Medicine, Northwestern UniversityVestrum HealthVestrum HealthVestrum HealthDepartment of Ophthalmology, Rush University Medical CenterDepartment of Ophthalmology, Feinberg School of Medicine, Northwestern UniversityAbstract Background Geographic atrophy (GA) is a significant cause of vision loss in patients with age-related macular degeneration (AMD). Current treatments are limited to anti-complement drugs, which have limited efficacy to delay progression with significant risk of complications. Levodopa (L-DOPA) is a byproduct of melanin synthesis that is associated with reduced development of neovascular AMD. In this study, we determined if L-DOPA was associated with a reduced likelihood of new-onset GA. Methods We performed a retrospective analysis in the Vestrum Health Retina Database. We included eyes with non-neovascular AMD without GA and 1–5 years of follow-up. Eyes were divided into two groups. Exposed to L-DOPA before or on the date of non-neovascular AMD without GA diagnosis, and eyes not exposed to L-DOPA. We extracted age, sex, AREDS2 status, dry AMD stage, smoking history, and conversion rate to GA at years 1 through 5. Propensity score matching was used to match L-DOPA and control groups. Cox proportional hazard regression, adjusting for age, sex, AMD severity, AREDS2 use, smoking status, and L-DOPA use was employed to calculate hazard ratios for new-onset GA detection. Results We identified 112,089 control and 844 L-DOPA exposed eyes with non-neovascular AMD without GA. After propensity score matching, 2532 control and 844 L-DOPA exposed eyes remained that were well-matched for age, sex, AMD severity, AREDS2 use, and smoking status. We found that L-DOPA exposure was associated with a significantly reduced likelihood (HR = 0.68, 95% CI: 0.48–0.95, P = 0.025) of new-onset GA detection. Conclusion L-DOPA use was associated with reduced detection of new-onset GA.https://doi.org/10.1186/s40662-024-00412-2Age-related macular degenerationGeographic atrophyL-DOPALevodopa
spellingShingle Kyle S. Chan
Nitika Aggarwal
Shannon Lawson
Nick Boucher
Mathew W. MacCumber
Jeremy A. Lavine
Levodopa is associated with reduced development of new-onset geographic atrophy in patients with age-related macular degeneration
Eye and Vision
Age-related macular degeneration
Geographic atrophy
L-DOPA
Levodopa
title Levodopa is associated with reduced development of new-onset geographic atrophy in patients with age-related macular degeneration
title_full Levodopa is associated with reduced development of new-onset geographic atrophy in patients with age-related macular degeneration
title_fullStr Levodopa is associated with reduced development of new-onset geographic atrophy in patients with age-related macular degeneration
title_full_unstemmed Levodopa is associated with reduced development of new-onset geographic atrophy in patients with age-related macular degeneration
title_short Levodopa is associated with reduced development of new-onset geographic atrophy in patients with age-related macular degeneration
title_sort levodopa is associated with reduced development of new onset geographic atrophy in patients with age related macular degeneration
topic Age-related macular degeneration
Geographic atrophy
L-DOPA
Levodopa
url https://doi.org/10.1186/s40662-024-00412-2
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