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Conclusions: PBM proves to be beneficial for improvement of vision and contrast sensitivity and a safe treatment for dry AMD in this pilot study. Larger studies are warranted to validate the findings from this study. INTRODUCTION: AMD is a retinal degenerative disease that causes irreversible, profound vision loss in people over the age of 60 years1. AMD occurs in two major forms: exudative (wet) and atrophic (dry) AMD. These two forms of AMD are both part of the same disease process continuum and share similar risk factors for their development. Exudative AMD is characterized by choroidal neovascularization (CNV). In contrast, atrophic AMD is characterized by retinal pigment epithelial (RPE) cell atrophy and subjacent photoreceptor degeneration. Factors involved in causing RPE cell injury and dysfunction have been shown to include oxidative stress, inflammation and genetic disposition2. Damage caused by oxidative stress and inflammation leads to progressive loss of cell function and thus contributes to the development of atrophic AMD. There are no proven treatments for the dry or atrophic form of AMD to date. Potential therapeutic approaches for atrophic AMD include inhibiting inflammatory responses as well as reducing oxidative stress secondary to anoxia. PBM otherwise known also as low level laser therapy (LLLT) when used in the red to near-IR range (630–1,000 nm) using low-energy lasers or light-emitting diode (LED) arrays has been shown to accelerate wound healing, improve recovery from ischemic injury in the heart and attenuate degeneration in the injured optic nerve 3 4 5 6 7 8. LED treatment significantly improved rod- and M-cone- mediated ERG responses in methanol-intoxicated rats 9. Ivandic and Ivandic have shown that LLLT with a laser diode aimed at the macular area (trans sclerally) in human subjects significantly improved visual acuity in a case series of both dry and wet AMD. Visual acuity in the control group remained unchanged. No adverse effects were observed in those undergoing therapy 10. We designed this study as the first globally to look at the effect of PBM with low powered LED (non coherent) devices shone through the pupil in patients with dry AMD. METHODS The study was designed as a prospective non-randomized interventional case series. Patients were identified prospectively as they presented to clinics run by two of us (GM and RD). We selected subjects with previously diagnosed dry age-related macular degeneration (AMD).PDF Image | dry Age-related Macular Degeneration Photobiomodulation
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