Levodopa in retinal disease: Dopamine pathways, neuroprotective mechanisms, and clinical evidence.
Levodopa in retinal disease: Dopamine pathways, neuroprotective mechanisms, and clinical evidence.
Where did the research take place?
The study site has not been established. Author addresses may differ from where the research occurred.
Tucson, US · Author affiliation
Department of Ophthalmology and Vision Science, The University of Arizona, Tucson, AZ, USA.Location evidence
Belfast, GB · Author affiliation
Centre for Public Health, Queen's University Belfast, Belfast BT12 6BA, UK.Location evidence
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Original abstract
We review the role of levodopa (L-DOPA), a dopamine precursor used to treat Parkinson disease, as a candidate for retinal neuroprotection, focusing on retinal dopamine biology, mechanisms of action, and evidence from preclinical and clinical studies. Selected experimental and clinical studies indicate that L-DOPA and related dopaminergic interventions influence multiple retinal pathways relevant to degeneration. L-DOPA, synthesized in the pigmented retinal pigment epithelium, activates GPR143 signaling and promotes the release of neuroprotective factors. In animal studies, L-DOPA supplementation rescued retinal development in albinism and reduced oxidative damage to photoreceptors. Epidemiologic analyses showed that patients on systemic L-DOPA had a delayed onset and a lower incidence of age-related macular degeneration (AMD). Small clinical studies in neovascular AMD demonstrated that adjunctive oral L-DOPA improved vision and reduced the burden of anti-vascular endothelial growth factor injections. Larger controlled trials are needed to define efficacy, optimal dosing, and long-term tolerability. Given its established pharmacology and ability to cross the blood-retinal barrier, L-DOPA is a promising candidate for therapeutic repurposing in ophthalmology.