Corneal laser procedure for vision improvement in patients with neovascular age-related macular degeneration and other retinal disorders involving central vision loss: a retrospective cohort study

Background: The purposes of this pilot retrospective observational cohort study are to determine: 1) the safety and efficacy of corneal photovitrification (CPV), a corneal laser procedure, for vision improvement in patients with neovascular age-related macular degeneration (nAMD) and other retinal disorders involving central vision loss, and 2) the correlation between post-treatment (post-treatment (Tx)) best-corrected distance visual acuity (BCDVA) and pre-Tx potential visual acuity (PVA). Methods: BCDVA measurements using ETDRS charts and PVA measurements using Gonzalez-Markowitz PVA charts were analyzed for 72 eyes that received a single CPV treatment. Results: Safety - No clinically significant complications or serious adverse events occurred. Efficacy – Mean BCDVA improved significantly from 20/303 (1.18 log of the minimum angle of resolution (logMAR), 26 letters) at pre-Tx to 20/208 (1.02 logMAR, 34 letters) at 1m post-Tx (p = 0.000001) for a cohort of 57 eyes, improving to 20/198 (1.00 logMAR, 35 letters; 11.6 mean letters gained) at 12m (p = 0.0009) for a cohort of 29 eyes. Mean pre-Tx PVA gains correlated well with mean BCDVA improvements at 1m, 3m, 6m and 12m post-Tx. Conclusions: Subject to a small sample size, the CPV corneal laser procedure is safe and efficacious for vision improvement in patients with nAMD and other retinal disorders involving central vision loss. The pre-Tx PVA correlates well with post-Tx BCDVA; the PVA test may be useful for screening of candidate eyes for CPV treatment and for managing expectations.