TOPLINE:

In patients with a diagnosis of early- or intermediate-stage nonneovascular age-related macular degeneration (AMD), exposure to levodopa was associated with a significantly reduced risk for conversion to neovascular AMD over 5 years, whereas exposure to dopamine agonists or dopamine receptor D2 agonists did not show a significant association.

METHODOLOGY:

• Researchers conducted a retrospective analysis using data from an ophthalmology data repository, including patients who received any eye care.
• They included patients with a diagnosis of intermediate-stage nonneovascular AMD in at least one eye; those with early- or intermediate-stage nonneovascular AMD in the fellow eye were also included.
• The study compared eyes with no exposure to a dopamine agonist with those exposed to any dopamine agonist, dopamine receptor D2 agonists, or levodopa. Eyes with new exposure to levodopa or dopamine receptor D2 agonists after diagnosis were excluded.
• Propensity score matching was performed to account for confounding factors, resulting in:
  • 571 eyes exposed to levodopa and 1713 eyes not exposed
  • 1785 eyes exposed to any dopamine agonist and 5355 eyes not exposed
  • 1046 eyes exposed to dopamine receptor D2 agonists (such as pramipexole and piribedil) and 3138 eyes not exposed
• Associations between exposure to these three agents and a new-onset neovascular AMD were evaluated.

TAKEAWAY:

• Exposure to levodopa was associated with a 47% reduced risk for conversion to neovascular AMD over 5 years (adjusted hazard ratio, 0.53; P = .028).
• Exposure to any dopamine agonist or to dopamine receptor D2 agonists showed no significant association with conversion to neovascular AMD.
• Factors such as older age (≥ 70 years or ≥ 75 years), neovascular AMD in the fellow eye, and intermediate stage of AMD were linked to an increased risk of developing neovascular AMD.

IN PRACTICE:

“These findings affirm the potential of L-DOPA [levodopa] as a therapeutic in preventing progression to neovascular AMD,” the researchers wrote.

SOURCE:

This study was led by Kyle S. Chan, MD, of the Department of Ophthalmology at the Northwestern University Feinberg School of Medicine in Chicago. It was published online on December 8, 2025, in Ophthalmology Retina.

LIMITATIONS:

The lack of fundus photography, optical coherence tomography, and fundus autofluorescence restricted the ability to validate diagnoses of AMD. The study focused on the intermediate stage of AMD, excluding many patients with early forms of the disease in both the eyes. Patients who received dopamine agonist treatment for Parkinson’s disease may have been lost to follow-up due to related health issues and mortality.

DISCLOSURES:

This study was supported by a research grant from the Illinois Society for the Prevention of Blindness and an unrestricted grant from Research to Prevent Blindness. One author disclosed consulting for Genentech and Line 6 Biotechnology and receiving research support from Therini Bio.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.