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calculated the total drusen volume and the mean central 1-mm drusen thickness within the ETDRS grid between the Bruch’s membrane and the fitted RPE segmentation line (Fig. 1). A 488-nm FAF image was employed to quantitatively assess GA. The area of homogenous hypo-autofluorescence on the FAF BL and subsequent images were manually marked using the IN- BUILT ‘draw’ command of the Heidel- berg software. Analysis of the absolute GA lesion area as well as the square root of the area was used in order to allow growth comparison independent of initial lesion size (Fig. 1) (Yehoshua et al. 2011). Statistical analyses Statistical analyses were performed using R (The R Project for Statistical Computing; https://www.r-project.org) version 3.0 or higher. Linear mixed- effects analyses were performed using the R package nlme. Graphs were generated using the R package ggplot2. Data were analysed using random Table1. BaselineDiseaseDistributionaccord- ing to AREDS Classification, and Study Outcome Measures. Baseline disease distribution according to AREDS classification intercept models with month as fixed effect, subjects as random effects and eye nested within subject. The random effects model is analogous to a paired t- test or repeated-measures analysis, but controls for correlation of treatment effects between eyes within subjects. We fit linear mixed-effects models accounting that the observations of eyes are not fully independent of one another as pairs of eyes are from the same subject. Two-sided p-values <0.05 were considered statistically sig- nificant. Results The study evaluated 42 eyes from 24 subjects, 66–95 years of age (mean 78.0 7.83). There were 15 females and 9 males. Baseline AMD disease demographics are presented in Table 1. Table 2. Summary table of results. Acta Ophthalmologica 2017 Thirteen subjects (31%) presented with GA of which nine subjects (21%) had definite foveal involvement visible on SD-OCT and FAF. Baseline values of clinical and mor- phological parameters are given in Table 1. All subjects had been taking AREDS supplementation prior to the intervention, and no changes were made to their current dosing regimen during the observational period. Functional outcome measures of BCVA and CS showed a significant positive effect immediately following the treatment (Table 2, Fig. 2). Mean ETDRS BCVA score improved by 5.9 letters immediately post-treatment with a significant difference (p < 0.001) that remained at a statistically significant level at visit 2 (p < 0.001; Table 2, Fig. 2). A total of 11.9% of eyes treated Measure BCVA letter BCVA letter Measure CS 1.5 CPD CS 1.5 CPD CS 3.0 CPD CS 3.0 CPD CS 6.0 CPD CS 6.0 CPD Measure Comparison BLtoV1 BLtoV2 Comparison BLtoV1 BLtoV2 BLtoV1 BLtoV2 BLtoV1 BLtoV2 Comparison BLtoV1 BLtoV2 Comparison BLtoV1 BLtoV2 BLtoV1 BLtoV2 Comparison BLtoV1 BLtoV2 Comparison BLtoV1 BLtoV2 Letter score increase +5.90 +5.14 Log CS increase +0.102 +0.080 +0.109 +0.166 +0.117 +0.10 mm3 decrease 0.024 0.029 lm change 3.78 0.34 0.36 3.39 mm change 0.021 0.026 mm3 decrease 0.066 0.1133 0.049 0.4639 score score p-value <0.001 <0.001 p-value 0.0113 0.0558 0.0224 0.0155 0.0029 0.0360 p-value <0.001 0.0206 p-value <0.001 0.8781 0.6872 0.1422 p-value 0.2043 0.1618 AREDS classification AREDS 2 AREDS 3 AREDS 4 GA RPD Baseline clinical and functional outcome measures Study variables at BL (units) ETDRS (letters) CS 1.5 CPD (log CS) CS 3.0 CPD (log CS) CS 6.0 CPD (log CS) Drusen volume (mm3) Central drusen thickness (lm) GA area (mm2) CRT (lm) RV (mm3) Number of eyes (%) 9 (21%) 20 (48%) 13 (31%) 13 (31%) 28 (67%) Mean SD 86.29 11.36 1.36 0.17 1.50 0.23 1.54 0.20 0.46 0.14 35.12 36.58 7.01 5.22 278.67 47.60 8.04 0.78 Drusen volume Drusen volume Measure Central drusen thickness Central drusen thickness CRT CRT GA area GA square root GA square root Measure RV RV p-value RPD = reticular pseudodrusen, SD = standard deviation, ETDRS = early treatment diabetic retinopathy study, CS = contrast sensitivity, CPD = cycles per degree, log CS = log contrast sensitivity, GA = geographic atrophy, CRT = central retinal thickness, RV = retinal volume. BL = baseline, GA = geographic atrophy, early treatment diabetic retinopathy study letter score (BCVA = best-corrected visual acuity), CS = contrast sensitivity at 1.5, 3.0 and 6.0 cycles per degree (CPD, log units), drusen volume reduction (mm3), central retinal drusen thickness (lm), retinal volume (RV, mm3) and central retinal thickness (CRT, lm). e273PDF Image | Photobiomodulation reduces drusen in macular degeneration
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