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Red Light Photobiomodulation

 

Red light therapy for AMD – summary

Scientific background: Experimental work and clinical studies have demonstrated the potential for red light to benefit retinal function in AMD, leading to both anatomical improvement and visual gain. The treatment is thought to work through improvement in blood flow, decreased inflammation and increased mitochondrial function. Recent studies of patients with AMD have concentrated on dry disease, but earlier studies also show certain benefits for patients with wet AMD.

 

New exciting research and clinical studies have found red light to also be of benefit in Dry Macular Degeneration. Improvements in vision and retinal anatomy have been achieved by decreasing the inflammation and recovering blood flow. Initial studies show a rapid effect, decreasing drusen, increasing blood flow and improved visual acuity which is maintained for over six months

Photobiomodulation (PBM) is a light-based therapy showing significant promise in the potential treatment of dry AMD. Therapy is delivered via the LumiThera Valeda device. Andrew Luff and Deb Sahu are specialist retinal consultants at Sapphire Eyecare treatment unit, based at Highcliffe Medical Centre, where this new treatment is now available.
Dry AMD has remained frustratingly resistant to intervention in spite of our massively increased knowledge of retinal pathophysiology, genetics and inflammatory pathways.
Light therapy, primarily with red and near-infrared wavelengths, has been shown beneficial for a number of pathologies throughout the body. The science of photobiomodulation (PBM) is developing rapidly with recent publications demonstrating impressive short-term results in the earlier stages of dry AMD. A 2017 paper ((Merry GF et al. Acta Ophthalmologica. 2017: 95: e270-277), showed improvement in both retinal morphology and visual function (particularly contrast sensitivity) following a short course of treatment. Photobiomodulation reduces drusen volume and improves visual acuity and contrast sensitivity in dry age-related macular degeneration.

Initial studies show a rapid effect with benefit maintained over six months. A second treatment at that point appeared once again to deliver a positive result but no longer-term data are, as yet, available. Further clinical trials are in progress but, given the weight of evidence and the current lack of any other effective treatment, this minimally invasive and very low-risk treatment appears worthy of consideration.

Scientific background:

Experimental work and clinical studies have demonstrated the potential for red light to benefit retinal function in AMD, leading to both anatomical improvement and visual gain. The treatment is thought to work through improvement in blood flow, decreased inflammation and increased mitochondrial function. Recent studies of patients with AMD have concentrated on dry disease, but earlier studies also show certain benefits for patients with wet AMD.
Patient selection
Suitable patients should have evidence of AMD sufficient to be considered for AREDS supplements. Visual acuity should be 6/36 or better in at least one eye. Patients judged to have significant cataract may undergo surgery after the initial treatment cycle. Those with bilateral AMD developing wet change in one eye may have bilateral treatment, but patients with bilateral wet AMD will be excluded until further data are available. Anti-VEGF injection should continue as directed by the treating centre.

Treatment protocol

A therapy cycle consists of three treatments per week for three consecutive weeks. Measurement visual acuity along with retinal photography and OCT scanning will be performed six weeks after the start of treatment.
On-going treatments
Further treatment cycles may be required after an interval of six months