Laser Intervention in Early Age Related Macular Degeneration Emily Caruso – LEAD trial Coordinator

AMD Macular degeneration is one of the leading causes of blindness in Australia.

Stages of AMD Early AMD Wet AMD Dry AMD

Treatment Currently there is only treatment for WET macular degeneration. Lucentis Eylea

Early AMD Vision is good Drusen present Diagnosis usually picked up on routine visit to the Optometrist. No signs of any late AMD progression

2RT nanosecond laser- Ellex Speckled effect Laser Killing sick RPE cells Healthy cells will divide, and bridge over the gap the laser has left New cells will function to clear away the debris in Bruch's Membrane. Gentle laser Doesn’t leave burns (like current lasers do) Painless.

2RT Pilot study The world first Pilot study of the Ellex nanosecond laser in the treatment of Early AMD ran for 3 years. 50 Participants All had 1 eye treated with the 2RT nanosecond laser

2RT Pilot study results Reduction in Drusen Improved Macular Function We are seeing these results in not only the treated eye but in some cases the fellow non-treated eye

Drusen Regression Baseline 9 months

Bilateral Effect Right Eye Baseline RE 3 months post laser to LE So drusen goes away in treated and some times in other eye

Bilateral Effect Before Treatment to LE 3 months post laser to LE

Bilateral Effect Before laser to RE 12 months after Laser to RE . A) Macular flicker sensitivities and drusen changes in both eyes of a patient aged 55, before (top) and 6mths after (bottom) laser treatment to right eye. Graphical representations of flicker visual field deviation and macular photo are shown. Note that the focal defect on the non-treated eye has resolved completely and the treated eye has improved, along with some drusen reduction (black arrows

LEAD STUDY With positive results from the Pilot study, we received an NHMRC grant to conduct the worlds first multi centred randomised control trial of nanosecond laser in the treatment of early AMD. (LEAD Trial)

LEAD Study Aim: To provide an Early intervention, which may slow or partially reverse the progression of the disease, before any late changes develop.

LEAD Update Recruitment will finish at the end of 2014. Aiming to have 150 participants at the RVEEH site. Overall recruitment aim is 350 participants. Multiple sites recruiting. Melbourne (2 sites) Sydney Adelaide Perth Northern Ireland

LEAD Inclusion criteria Bilateral high-risk early AMD Best corrected VA 6/12 or better in each eye 50-95 years of age MAIA perimetry result of <25 dB in one eye in the same area on 2 tests

THANK YOU! Any Questions