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

Abstract

Purpose: To evaluate visual acuity and morphologic changes after photobiomodulation (PBM) for patients affected with large soft drusen and/or drusenoid pigment epithelial detachment associated with dry age-related macular degeneration. Method: Twenty eyes with large soft drusen and/or drusenoid pigment epithelial detachment age-related macular degeneration were included and treated using the LumiThera Valeda Light Delivery System. All patients underwent two treatments per week for 5 weeks. Outcome measures included best-corrected visual acuity, microperimetry-scotopic testing, drusen volume, central drusen thickness, and quality of life score at baseline and month 6 (M6) follow-up. Data of best-corrected visual acuity, drusen volume, and central drusen thickness were also recorded at week 5 (W5). Results: Best-corrected visual acuity significantly improved at M6 with a mean score gain of 5.5 letters (P = 0.007). Retinal sensitivity decreased by 0.1 dB (P = 0.17). The mean fixation stability increased by 0.45% (P = 0.72). Drusen volume decreased by 0.11 mm3 (P = 0.03). Central drusen thickness was reduced by a mean of 17.05 µm (P = 0.01). Geographic atrophy area increased by 0.06 mm2 (P = 0.01) over a 6-month follow-up, and quality of life score increased by 3,07 points on average (P = 0.05). One patient presented a drusenoid pigment epithelial detachment rupture at M6 after PBM treatment. Conclusion: The visual and anatomical improvements in our patients support previous reports on PBM. PBM may provide a valid therapeutic option for large soft drusen and drusenoid pigment epithelial detachment age-related macular degeneration and may potentially slow the natural course of the disease.

Current Applications and Future Perspectives of Photobiomodulation in Ocular Diseases: A Narrative Review

“…Twenty eyes underwent PBM treatment with 2 sessions per week for 5 weeks. The results showed a significant improvement in visual acuity, drusen volume, and thickness at the 6-month follow-up visit [46]. Despite all the positive effects described in the above-mentioned studies, treatment-related adverse effects were reported.…”

“…Despite all the positive effects described in the above-mentioned studies, treatment-related adverse effects were reported. Benlahbib and co-authors described a slight increase in geographic atrophy area and a drusenoid pigment epithelial detachment rupture in a patient [46]. In addition, in late 2023, Parodi and colleagues documented a case involving a 63-year-old woman with a subfoveal drusenoid pigment epithelium detachment (D-PED) that collapsed two weeks after the last session of (PBM).…”