Effect of topical isopropyl unoprostone on macular atrophy progression in eyes with exudative age-related macular degeneration

Background: To evaluate the efficacy and safety of topical isopropyl unoprostone (IU) in treating macular atrophy in age-related macular degeneration (AMD) patients. Methods: Fifty-two AMD patients with macular atrophy were included and randomly assigned (1:1) to the treatment (topical 0.15% IU) or placebo group. Subjects used study eye drops 3 times a day for 54 weeks. The macular atrophy was documented on fundus autofluorescence photographs and measured using RegionFinder. The enlargement rate of macular atrophy and the changes in visual acuity were examined statistically between baseline and 54 weeks. Results: Forty-eight subjects were included in the analyses because 4 subjects withdrew fromthe study. The differences between the IU and placebo groups in mean and median area of macular atrophy were not statistically significant at baseline. The baseline median lesion size ofmacular atrophy was 2.33mm² in the IU group and 1.63mm² in the placebo group (P=0.51). The intergroup difference in the enlargement ratio of macular atrophy (21±15%in the IU group and 111±96%in the placebo group) was statistically significant (P< 0.001). Additionally, visual acuity tended to improve over baseline in the IU group. No serious adverse events were observed. Conclusions: Topical IU therapy is safe and effective for treating macular atrophy in AMD patients.