Abstract:  Objective To investigate the short-term (6-month) safety and efficacy of laser enhanced anti-VEGF precise permeation (LEAP) therapy based on indocyanine green angiography localization in patients with neovascular age-related macular degeneration (nAMD). Design A prospective, non-randomized controlled study. Participants A total of 112 patients (122 eyes) with nAMD who received intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) drugs at the First Medical Center and the Third Medical Center of Chinese PLA General Hospital from September 2023 to March 2026. Methods According to patients' voluntary treatment willingness, the subjects were divided into LEAP treatment group and simple anti-VEGF intravitreal injection group. The number of treatments and efficacy indicators at the 6-month follow-up were observed and compared between the two groups, and the differences in treatment burden and efficacy of the two regimens were evaluated. Main Outcome Measures Number of treatments at the 6-month endpoint, best corrected visual acuity (BCVA), central macular thickness (CMT), height of subretinal fluid (SRF), and height of pigment epithelial detachment (PED). Results Before enrollment in the study, the mean number of intravitreal injections in the LEAP treatment group was (5.77±3.73). At the 6-month short-term endpoint, the LEAP group achieved lesion stability with a mean treatment count of only (0.48±0.91) times, which was significantly lower than (2.79±1.03) times in the intravitreal injection alone group (z=-8.568, P＜0.001).There were no significant between-group differences in efficacy indicators including best corrected visual acuity (P=0.058), central macular thickness (P=0.663), subretinal fluid height (P=0.082), and pigment epithelial detachment height (P=0.242). All intragroup efficacy parameters were significantly improved compared with baseline (all P<0.05). No adverse events related to LEAP treatment were observed during the study period. Conclusion LEAP therapy serves as a novel strategy to remarkably reduce the treatment frequency for nAMD, with non-inferior efficacy and safety compared with conventional simple anti-VEGF intravitreal injection therapy.

Key words: Neovascular age-related macular degeneration, Laser therapy, Anti-VEGF, Drug permeation