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LLLT IMPROVES VISION IN PATIENTS WITH AMD 243 Right eye of a 64-year-old patient with early-stage Determination of laser power Initial experimentation on a freshly enucleated pig eye aimed to determine the optimum power level of laser energy to be used in this study. By using a low sub-thermal dose of radiation (10.5 mW), only a small proportion of the energy reached the retina (Table 1). The largest proportion was ab- sorbed by the sclera, choroidea, and RPE. The data indicated that a power output of 10.3 mW was required for the laser light to pass through all layers of the eye. Demographic characteristics In total, 203 patients (90 men and 113 women) with AMD of various stages (n 348 eyes) and a mean age of 63.4 5.3 y were included in the study. All patients received treatment as planned; none of the patients withdrew from the study. One hundred ninety-three patients (mean age 64.6 4.3 y) were treated using LLLT; of 328 treated eyes, 146 (45%) FIG. 2. AMD. Results FIG. 3. Fluorescein angiogram of exudative advanced AMD in the left eye of a 62-year-old patient. eyes were without cataracts, and 182 (55%) eyes were with cataracts. Eye examination revealed that 230 eyes had drusen or were depigmented; geographic atrophy was noted in 12 eyes. Progressive, exudative AMD was diagnosed in 86 eyes with no other disorders. Examples of early-stage and ad- vanced AMD are shown in Figs. 2 and 3, respectively. The control group receiving mock treatment comprised 10 patients (20 eyes) with all stages of AMD (4 men and 6 women) with a mean age of 62.3 6.4 years. Changes in visual acuity There was a statistically significant increase in visual acu- ity (p 0.00001, end of study versus baseline) for both pa- tients with and those without cataracts. The improvement in visual acuity was maintained for 3–36 mo. By contrast, vi- sual acuity remained unchanged in all patients in the con- trol group. In patients without cataracts (Table 2), visual acuity im- proved in 142/146 eyes (97.3%; p 0.00001): by one row of TABLE 2. VISUAL ACUITY BEFORE AND AFTER LLLT IN PATIENTS WITH AMD WITHOUT CATARACTS (N 146 EYES) Before therapy 1 2 1 21 11 234121 453697 1 1 4 12 31 4 9 11 16 1 1 5 4 8 10 5 13 22 47 15 16 1.00 0.70 0.60 0.55 0.50 0.40 0.30 0.20 0.10 0.50 0.10 After therapy Visual 20/ 20/ 20/ 20/ 20/ 20/ 20/ 20/ 20/ 20/ 20/ Log acuity 400 200 100 80 70 60 50 40 30 25 20 MAR Sums 20/400 1 20/200 2 20/100 20/80 1 20/70 1 20/60 20/50 3 20/40 2 20/30 13 20/25 34 20/20 53 20/16 36 Sums 146 Number of eyes are in bold type. log MAR, logarithmic minimal angle resolution.PDF Image | Low-Level Laser Therapy Improves Vision in Macular Degeneration
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