What Do The Latest Studies Show About Red Light Therapy For Dry Macular Degeneration? By Dr Rupal Morjaria, Consultant Ophthalmologist

Recent research has shown encouraging 2 year results with intermediate dry macular degeneration, looking at reading speed, visual acuity and change in scan appearance.

As a Consultant Ophthalmologist and Medical Retina Specialist, this is an exciting development in an area of retinal medicine where treatment options have traditionally been limited.

The short answer

There is promising evidence that red light therapy may help certain people with dry age related macular degeneration (AMD).

A major clinical study called LIGHTSITE III investigated photobiomodulation using the Valeda Light Delivery System in people with intermediate dry AMD.

The latest results found improvements in vision in many of the eyes receiving treatment. The study also found encouraging evidence that fewer treated eyes progressed to geographic atrophy, an advanced form of dry AMD.

Importantly, the treatment demonstrated a favourable safety profile during the study, with no signs of light induced retinal damage.

This does not mean red light therapy is a cure for macular degeneration or that it is suitable for everybody. However, it represents an important and promising development for people living with dry AMD.

What did the LIGHTSITE III study find?

The LIGHTSITE III study investigated photobiomodulation in people with intermediate dry AMD.

It included 100 patients and 148 eyes and compared patients receiving photobiomodulation with a sham treatment group.

Rather than going deeply into the study design, the important part for patients is what happened to their vision.

At 21 months, the eyes receiving photobiomodulation showed an average improvement of 6.2 letters on a standard vision chart.

Among the treated eyes:

• Around 62% gained at least 5 letters

• Around 23% gained at least 10 letters

• A smaller proportion gained 15 letters or more

The study also reported improvements in vision related quality of life.

These results do not mean that every patient will experience an improvement, and the amount of benefit can vary considerably between individuals.

However, seeing measurable improvements in visual function is particularly interesting in a condition where historically much of the focus has been on attempting to slow further deterioration.

Could red light therapy also slow dry AMD?

This may be one of the most interesting findings.

As dry AMD progresses, some people develop geographic atrophy. This involves progressive loss of retinal cells and can eventually affect central vision.

After 24 months, new geographic atrophy developed in approximately 7% of eyes receiving photobiomodulation compared with 24% of eyes receiving the sham treatment.

That difference is encouraging and raises the possibility that photobiomodulation may have a role not only in visual function but potentially in modifying the progression of dry AMD.

However, this needs to be interpreted carefully.

LIGHTSITE III provides encouraging evidence, but research into photobiomodulation is continuing. Retinal specialists are still establishing precisely which patients benefit most, how long benefits persist and where this treatment should sit within the wider management of dry AMD.

Is red light therapy safe?

The LIGHTSITE III study reported a favourable safety profile.

Importantly, researchers found no signs of phototoxicity, meaning there was no evidence that the treatment caused light induced damage to the retina during the study.

This is an important finding because the treatment works by delivering light directly towards the eye.

However, patients should not attempt to recreate the treatment using household red lights, beauty devices or commercially available light therapy equipment.

Photobiomodulation for AMD uses specific wavelengths and carefully controlled treatment protocols delivered using specialist medical technology.

Can red light therapy reverse macular degeneration?

At present, I would not describe photobiomodulation as a cure or say that it reverses macular degeneration.

Once retinal cells have been permanently lost, treatment cannot simply recreate them.

What makes the emerging evidence interesting is that some patients experienced measurable improvements in visual function, while the study also identified changes suggesting a potential effect on disease progression.

This is an important distinction.

The aim is not to promise that damaged eyesight will return to normal. It is to explore whether supporting the remaining retinal cells could help patients make better use of the vision they still have and potentially protect retinal function for longer.

Why specialist assessment matters

Macular degeneration can vary considerably from one person to another.

Two patients who have both been told they have “dry AMD” may have different retinal appearances, different levels of vision and different stages of disease.

As a Consultant Ophthalmologist and Medical Retina Specialist, I assess the retina alongside your symptoms, vision and detailed retinal imaging to establish what type of macular degeneration is present and what options may be appropriate.

With emerging treatments such as photobiomodulation, selecting the right patient is particularly important.

The bottom line

The latest LIGHTSITE III results provide encouraging evidence that, in appropriately selected patients with intermediate dry AMD, treatment may:

• Improve visual acuity

• Provide measurable improvements in vision for some patients

• Improve aspects of vision related quality of life

• Potentially reduce progression towards geographic atrophy

• Achieve these benefits with a favourable safety profile in the clinical study

This does not mean that red light therapy is a cure, nor will every patient experience the same improvement.

However, for a condition where treatment options have historically been limited, the results represent a promising development.

Ultimately, the most useful question may not simply be:

“Does red light therapy work for macular degeneration?”

But:

“Could red light therapy be suitable for my type and stage of macular degeneration?”

Ready to take the next step?

If you have dry macular degeneration and would like to understand whether photobiomodulation may be appropriate for your eyes, a specialist retinal assessment can help establish the type and stage of your condition.

Following a detailed assessment, I can explain your retinal findings, discuss the evidence behind treatment and advise you on the options most appropriate for your individual eyes.

Contact details & appointments, click here.