Levodopa Medication Influences Wet AMD

Levodopa and DRD2 agonists are commonly prescribed in older patients suffering from Parkinson’s disease. Recent research suggests that these therapies may have protective effects against neovascular AMD progression. Photo: Mohammad Rafieetary, OD. Click image to enlarge. Researchers from Harvard, Stanford and Texas A&M conducted a study to determine whether dopamine receptor D2 (DRD2) agonists and levodopa, a dopamine precursor, have potential protective effects against neovascular age-related macular degeneration (nAMD) progression. Researchers published their findings in American Journal of Ophthalmology.Multiple groups were evaluated in this comparative study. Patients on levodopa with or without carbidopa were placed into groups where they were compared to patients on either pantoprazole or gabapentin, pharmaceuticals with no known effect on nAMD. Similarly, patients on a DRD2 agonist were placed into comparator groups with patients on either pantoprazole or gabapentin. The comparator groups were as follows:levodopa ± carbidopa (n=1312) vs. pantoprazole (n=1312)levodopa ± carbidopa (n=1675) vs. gabapentin (n=1675)DRD2 agonists (n=1603) vs. pantoprazole (n=1603)DRD2 agonists (n=2779) vs. gabapentin (n=2779)“In our retrospective target trial emulation of dopamine-enhancing therapies, levodopa with or without carbidopa use was associated with an approximately 30% reduction in the three-year risk of conversion to nAMD across two distinct comparator groups,” researchers stated in their paper. “DRD2 agonists were not associated with a statistically significant difference in risk of conversion to nAMD across either comparator group.”As the researchers pointed out, no significant results were found in either of the DRD2 comparator groups. However, the levodopa ± carbidopa comparator groups showed a reduced three-year risk of progression from non-neovascular to nAMD. In the levodopa ± carbidopa vs. pantoprazole group, a hazard ratio of 0.67 was reported with a cumulative incidence of progression from non-neovascular to nAMD of 4.9% for the levodopa ± carbidopa cohort and 7.3% for the pantoprazole cohort. Similarly, a hazard ratio of 0.69 was reported in the levodopa ± carbidopa vs. gabapentin group with a cumulative incidence of progression from non-neovascular to nAMD of 5.5% for the levodopa ± carbidopa cohort and 8.5% for the gabapentin cohort.“These findings implicate dopaminergic signaling in AMD pathogenesis and support further investigation of this pathway,” researchers said. “Prospective studies are warranted to validate these associations.”Click here for the journal source. Fazal O, Loya A, Muayad J, et al. Dopamine-enhancing therapies and risk of neovascular AMD conversion: A target trial emulation. Am J Ophthalmol. June 23, 2026. [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.