AMD Eyes Treated with L-dopa Linked to Reduced Conversion to Later Stages

Recent findings affirm the potential of L-dopa as a therapeutic in preventing progression to neovascular AMD. Photo: Carolyn Majcher, OD. Click image to enlarge. Levodopa (L-dopa), a precursor to dopamine in the melanin synthesis pathway and a mainstay of Parkinson’s disease therapy, has been proposed as a potential agent for delaying progression to advanced AMD, neovascular AMD and geographic atrophy. Researchers from the Sight Outcomes Research Collaborative (SOURCE) consortium hypothesized that overall dopamine agonist exposure, i.e., exposure to L-dopa as well as to dopamine D2 receptor agonist, would reduce the likelihood of conversion of eyes with AMD to its neovascular form. However, their recent study found that only exposure to L-dopa led to a 47% reduced likelihood of conversion to neovascular AMD.“Overall, these findings support the utility of a rigorous clinical trial investigating the effects of L-dopa on progression of AMD,” the study authors wrote in their paper, which was published in Ophthalmology Retina.The study included eyes with a diagnosis of early- or intermediate-stage AMD in one eye. After propensity score matching, there were 1,785 dopamine agonist–exposed eyes and 5,355 control eyes. Older age groups (75 to 79, 80 to 84 and 85 or greater), female sex, non-white race, active tobacco use, neovascular AMD in the fellow eye and intermediate AMD stage were associated with increased risk of conversion to neovascular AMD. Exposure to dopamine receptor D2 agonist had no significant association.“Our study offers unique insight, given it analyzes data from encounters in the academic medical setting, independent of private practice and claims-based databases studied in previous investigations,” the researchers highlighted.They noted that information about fundus photography, OCT and fundus autofluorescence were also not available, limiting validation of diagnoses, specifically early vs. intermediate AMD. Also, their study design captured patients with intermediate-stage AMD in at least one eye. Therefore, many patients with early AMD in both eyes were not analyzed. Therefore, these data are not broadly applicable to all patients with early AMD.Click here for the journal source. Chan KS, Congivaram HTS, Cuamatzi-Castelan AS, Lavine JA, on behalf of the SOURCE Consortium. Levodopa and dopamine agonists in neovascular age-related macular degeneration in the Sight Outcomes Research Collaborative Database. Ophthalmol Retina. December 8, 2025. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.