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J. Clin. Med. 2020, 9, 1001 12 of 13 2–4). Both 670 and 790 nm are red and infra-red wavelengths and so the effects are likely to be complimentary. The exact effect of 590 nm light on the retina is unclear and there is no obvious reason for its use. Unlike our study results, the changes in visual function were also observed from as early as three weeks and structural changes in three months, indicating the need for a randomized controlled trial to ensure that the study results are clinically meaningful and are not confounded by test-retest variability. As the therapy works widely in animal models including normal ageing and induced pathology, it is likely that the window of treatment opportunity, dosing and timing of intervention need to be investigated further. It is possible that there may be an age-dependent time frame where rods can be rescued to enhance scotopic thresholds. As the therapy is suggestive of rod function improvement in healthy ageing, further research is required to establish the optimal age window that would be benefit from treatment. Author Contributions: Conceptualization, S.S., C.S., and G.J.; methodology, C.S., M.K.G.; formal analysis, M.K.G, S.C. and S.G.; investigation, C.S. and M.K.G.; resources A.B., S.S. and V.C.; supervision; S.S. writing—original draft preparation, S.S., M.K.G. and G.J; writing—review and editing, S.S., M.K.G., S.C., G.J. and A.B.; funding acquisition, S.S. and G.J. All authors have read and agreed to the published version of the manuscript. Funding: This research was funded by Fight For Sight Charity, grant number 1409 and Moorfields Eye Charity. Conflicts of Interest: The authors declare no conflict of interest. References 1. Curcio, C.A. Photoreceptor topography in ageing and age-related maculopathy. Eye 2001, 15, 376–383. [CrossRef] [PubMed] 2. Ramrattan, R.S. Morphometric analysis of Bruch’s membrane, the choriocapillaris, and the choroid in aging. Investig. Ophthalmol. Vis. Sci. 1994, 35, 2857–2864. 3. Ko, F. Associations with retinal pigment epithelium thickness measures in a large cohort: Results from the UK biobank. Ophthalmology 2017, 124, 105–117. [CrossRef] [PubMed] 4. Ferris, F.L. Clinical classification of age-related macular degeneration. Ophthalmology. 2013, 120, 844–851. [CrossRef] [PubMed] 5. Sivaprasad, S. Perspectives on reticular pseudodrusen in age-related macular degeneration. Surv. Ophthalmol. 2016, 61, 521–537. [CrossRef] 6. Owsley, C. Associations between abnormal rod-mediated dark adaptation and health and functioning in older adults with normal macular health. Investig. Ophthalmol. Vis. Sci. 2014, 55, 4776–4789. [CrossRef] 7. Jackson, G.R.; Owsley, C.; Curcio, C.A. Photoreceptor degeneration and dysfunction in aging and age-related maculopathy. Ageing Res. Rev. 2002, 1, 381–396. [CrossRef] 8. Tan, R.; Guymer, R.H.; Luu, C.D. Subretinal Drusenoid Deposits and the loss of rod function in intermediate age-related macular degeneration. Investig. Ophthalmol. Vis. Sci. 2018, 59, 4154–4161. [CrossRef] 9. Flynn, O.J.; Cukras, C.A.; Jeffrey, B.G. Characterization of rod function phenotypes across a range of age-related macular degeneration severities and subretinal drusenoid deposits. Investig. Ophthalmol. Vis. Sci. 2018, 59, 241–2421. [CrossRef] 10. Stone, J. The locations of mitochondria in mammalian photoreceptors: Relation to retinal vasculature. Brain Res. 2008, 1189, 58–69. [CrossRef] 11. Kokkinopoulos, I. Age-related retinal inflammation is reduced by 670 nm light via increased mitochondrial membrane potential. Neurobiol. Aging 2013, 34, 602–609. [CrossRef] [PubMed] 12. Gkotsi, D. Recharging mitochondrial batteries in old eyes. Near infra-red increases ATP. Exp. Eye Res. 2014, 122, 50–53. [CrossRef] [PubMed] 13. Kam, J.H. Fundamental differences in patterns of retinal ageing between primates and mice. Sci. Rep. 2019, 9, 12574. [CrossRef] [PubMed] 14. Hamblin, M.; Demidova, T. Mechanisms of low level light therapy. Proc. SPIE 2006, 6140, 1–12. 15. Karu, T. Primary and secondary mechanisms of action of visible to near-IR radiation on cells. J. Photochem. Photobiol. B 1999, 49, 1–17. [CrossRef]PDF Image | 670 nm Photobiomodulation in Age-Related Macular Degeneration
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