Dual Antiplatelet Therapy and Geographic Atrophy in AMD

Researchers investigated the impact of dual antiplatelet therapy on the progression of geographic atrophy (GA) in patients with age-related macular degeneration (AMD), as well as potential predictive factors for rapid GA growth. According to the study, published in Frontiers in Ophthalmology, routine use of dual antiplatelets was associated with reduced progression of GA. The authors also suggested that drusen-related GA could be a generalized form of choroidal vascular alterations.

This retrospective cohort study enrolled one eye from consecutive patients with unifocal GA from 2018 to 2021. Participants were divided into those receiving dual antiplatelet therapy with daily clopidogrel 75 mg and aspirin 81 mg as the study group and those not receiving antiplatelets as the control group.

Dual Antiplatelets Effectively Reduce GA in AMD

The researchers used red-filtered fundus autofluorescence to assess GA at baseline and month 3, 6, and 12. The primary end point was absolute change in square root area at 12 months. Age and square root at baseline were comparable between the study (24 eyes; 1.2 ± 0.27 mm) and control (22 eyes; 1.8 ± 0.41 mm; P=.23) groups.

After correcting for age and presence of soft drusen or reticular pseudodrusen at month 12, the researchers found that patients receiving dual antiplatelet therapy had fewer changes in the square root area than those in the control group (0.097 vs 0.17 mm; P=.02). Additionally, the researchers noted that the presence of drusen was a significant predictive factor for increased GA progression and choroidal thickness reduction.

Ultimately, the authors summarized that “the GA growth appeared to be decelerating in patients who were on continuous dual antiplatelet therapy,” and they suggested that “drusen-associated GA may represent a subtype of atrophic AMD that possesses diffuse and more progressive choroidal nonperfusion than GA without drusen.”

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