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Acta Ophthalmologica 2017 Fig. 2. (A) Photobiomodulation (PBM) leads to significant improvement in early treatment diabetic retinopathy study (ETDRS) letter score (absolute plot – jitter) in individual subjects. The bold dotted line indicates the overall mean. (B) Contrast sensitivity (CS; 3.0 CPD) in logCS change from baseline (BL) following PBM treatment (absolute plot – jitter) in individual subjects. The bold dotted line indicates the overall mean. (C) This panel indicates the percentage of eyes presenting with one, two and three line ETDRS letter gain at visit 1 ( = immediate post-treatment, 3 weeks after BL). (D) Drusen volume measurements in mm3 change from BL following PBM treatment (absolute plot – jitter) in individual subjects. The bold dotted line indicates the overall mean. Fig. 3. Visual acuity change in magnitude categorized by baseline (BL) VA scores. Eyes with a BL VA letter score of between 70 and 89 (Snellen equivalent of 20/80–20/32) appeared to respond to photobiomodulation treatment with a high percentage gaining greater than five letters. Eyes with lower (60–69 letters) or higher (≥90 letters) BL VA letter score were less likely to gain more than five letters. gained (≥11 ETDRS letters) and 59.5% of eyes achieved more than a one line increase from BL at visit 1 (Fig. 2). Contrast sensitivity was significantly improved at 1.5, 3.0 and 6.0 CPD at visit 1 immediately post-treatment with p-values of 0.01, 0.02 and 0.003, respec- tively (Table 2, Fig. 2). There was a significant correlation between CS and VA benefits (Pearson = 0.54; Spear- man = 0.6). Further subgroup analysis of the BCVA data was employed to evaluate whether the BL score is indicative of the magnitude of change for potential improvement following PBM treat- ment. Although the linear regression analysis of the change in BCVA as a function of BL revealed that the BL score was not associated with the increase in visual acuity (r2 = 0.049, p = 0.16), the majority of responders with greater than five letters improve- ment had a BL score of between 70 and 89 letters (Snellen equivalent of 20/80– 20/32) (Fig. 3). This group also had the greatest number of responders with a 15 or more letter gain. Patients with better (≥90 letters) or lower (60–69 letters) BL scores were less likely to gain more than five letters (Fig. 4). Outcome measures of drusen volume and central drusen thickness showed a significant reduction immediately fol- lowing the 3-week treatment at visit 1 (p < 0.001). At visit 2, drusen volume was still significantly reduced (p = 0.02; Table 2, Fig. 2). There were no signifi- cant changes in CRT, GA area or RV during the observational period. Representative segmented section scans illustrating the drusen regression following therapy is given in Figs 4 and 5. None of the patients developed new wet AMD or GA during the study analysis period of 3 months. Discussion The previous TORPA study was the first to show improvement in functional parameters using LED light sources for dry AMD subjects (Merry et al., PBM for dry AMD, ARVO, 2012). Significant improvement in BCVA and CS was observed immediately following PBM and was maintained at 1 year. The results from the current study further corroborate the improvement in func- tional measures (BCVA and CS) seen in the earlier TORPA study and demon- strate the benefits of PBM to significant improvement in anatomical end-points of the disease. This has not been studied in any previous PBM intervention for AMD. e274 more than two linesPDF Image | Photobiomodulation reduces drusen in macular degeneration
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