Effects of Photobiomodulation in Patients Presenting with Reticular Pseudodrusen: A Retrospective Observational Case Series Study

Abstract

Background and Objectives: The purpose of this study is to describe the effects of photobiomodulation on drusen regression with patients presenting with reticular pseudodrusen (RPD). Materials and Methods: This study is a retrospective observational case series study including patients presenting with RPD who underwent treatment by photobiomodulation. All patients underwent a complete ophthalmic examination and multimodal imaging prior to treatment, including spectral-domain optical coherence tomography (SD-OCT). Eyes were treated two times per week for six consecutive weeks. Best corrected-visual acuity (BVCA) was measured prior and after treatment for all patients. The number of RPD on the SD-OCT scans centered on the macula and stages of RPD was noted at baseline and 6 months after the first treatment session. Results: Five eyes of five patients were included in the study. Mean BCVA did not change 6 months after treatment compared to baseline. Mean number of RPD per eye was 112.60 +/− 48.33 RPD at baseline and 111.6 +/− 49.29 in the same area 6 months after treatment. Changes in RPD distribution according to RPD classification were observed before and after treatment with photobiomodulation. Changes in distribution mostly concerned stages 1 and 3 RPD: Total number of stage 1 RPD was 289 and increased to 324 after treatment. Total number of stage 3 RPD was 97 at baseline and decreased to 67 6 months after treatment. Percentage of stage 1 RPD increased from 46% to 56% after treatment. Percentage of stage 3 RPD decreased from 20% to 13% after treatment. Conclusions: Changes in RPD distribution were observed before and after treatment with photobiomodulation. The number of stage 3 reticular pseudodrusen decreased while number of stage 1 reticular pseudodrusen increased after treatment.

LIGHTSITE III: 13-Month Efficacy and Safety Evaluation of Multiwavelength Photobiomodulation in Nonexudative (Dry) Age-Related Macular Degeneration Using the LumiThera Valeda Light Delivery System

“…No progression of RPD into greater stages was observed. 18 Photobiomodulation was well tolerated, with a favorable safety and compliance profile. Compliance rates for both PBM and Sham groups were high throughout each treatment series with a higher rate noted in the PBM group.…”

“…Recent ophthalmologic clinical trials, including LIGHTSITE I and II, evaluated the effect of multiwavelength PBM using the Valeda light delivery system and found improvement in clinical vision outcomes and anatomical correlates of the disease. [17][18][19] LIGHTSITE III further investigates the effects of PBM treatment in early/intermediate dry AMD.…”

Improvement in Central Serous Chorioretinopathy Following Multiwavelength Photobiomodulation Treatment – Case Report

“…PBM treatment has gained interest in the field of ophthalmology due to its mechanistic actions and recent studies showing benefits in a variety of indications including age-related macular degeneration [10][11][12][13][14][15][16][17][18][19][20]. The threat of vision loss and the limited/invasive treatment strategies available in many ocular conditions, including CSCR, results in extreme stress and diminished outlook in many patients.…”

Photobiomodulation therapy for large soft drusen and drusenoid pigment epithelial detachment in age-related macular degeneration: a single-center prospective pilot study

“…We previously demonstrated that PBM on reticular pseudodrusen, in five cases, showed a decreased number of stage 3 reticular pseudodrusen, which is in accordance with anatomical benefits in our study. 14 Previous reports revealed that drusen development and resolution are in a constant course of change. 3,15 Drusen resolution can leave behind GA. 3 Large dPED can also collapse and disappear without leading to additional photoreceptors and RPE disruption and loss.…”

“…We previously demonstrated that PBM on reticular pseudodrusen, in five cases, showed a decreased number of stage 3 reticular pseudodrusen, which is in accordance with anatomical benefits in our study. 14…”