Light therapy might help ease 'dry' form of macular degeneration

Light therapy could be a useful treatment for the most common form of age-related macular degeneration, a study says.

The therapy, called photobiomodulation or "red light" therapy, can reduce the risk of vision loss and slow progression of the "dry" form of macular degeneration, researchers reported.

About eight out of 10 people with macular degeneration have the "dry" form of the disease. They slowly lose central vision as the macula—a small but important area in the center of the retina—becomes thinner and accumulates tiny clumps of protein called drusen.

There are effective drugs available for people with "wet" AMD, in which leaking blood vessels damage the macula, Boyer said.

But people with dry AMD have few options to protect their eyesight, aside from changes to their diet and lifestyle, he said.

Photobiomodulation uses different wavelengths of light to improve function in the cells of the retina, keeping them healthier for longer. It's a technique already used in eye diseases like diabetic retinopathy, researchers said.

For this study, researchers recruited 100 patients with high-risk dry AMD, and randomly assigned to receive either photobiomodulation or a placebo. Treatment was administered three times a week for three weeks, repeated every four months.

After two years, 53% of patients receiving light therapy had significant improvement in their vision as measured by an eye chart. By comparison, 18% of patients in the placebo group had a significant decline in their eye chart test results.

The light therapy patients also had a 73% reduction in their progression toward geographic atrophy, the last stage of AMD, while untreated patients had a 24% increase in disease progression, results show.

The U.S. Food and Drug Administration is expected to decide in December whether to approve photobiomodulation for treatment of dry AMD, researchers said.

After two years, 53% of patients receiving light therapy had significant improvement in their vision as measured by an eye chart. The light therapy patients also had a 73% reduction in their progression toward geographic atrophy, the last stage of AMD. These are great results.

This therapy is available today for diabetic retinopathy and could be used by your doctor, before final FDA approval in December.

Drusen are small yellow deposits of fatty proteins (lipids) that accumulate under the retina.

Researchers analysed data from 30,953 individuals aged 50 years or older who participated in two European studies: European Eye Epidemiology (E3) Consortium and the Rotterdam study. The research showed that both HDL cholesterol and triglycerides showed the strongest association with drusen (yellow spots) and early AMD.

In the Blue Mountains Eye Study, statins decreased the incidence of soft drusen but not early AMD.

Research conducted by the National Eye Institute found a nutritional supplement formulation that may help stave off the advanced stages of AMD. The formulation, known as AREDS2, contains vitamin C, vitamin E, lutein, zeaxanthin, zinc, and copper.

My own theory is that the blood flow is decreased by the drusen causing hypoxia in the eye. AMD runs in my family, so when a patient came to me with it about ten years ago, I researched it extensively.

The decrease is blood flow causes vascular endothelial growth factor (VEGF) to cause angiogenisis which in turn causes wet AMD. Injections in the eye of an anti VEGF such as the drug Avastin are used to decrease angiogenesis.

Often people have wet AMD in one eye and dry AMD in the other.

I found in my client that she had a blood clotting disorder caused by a blood protein cofactor. (I noticed the bruises on her legs were not healing.) There are many cofactor disorders such as von Willebrand disease or Factor V Leiden, which can also influence anemia.

B12 deficiencies and/iron can trigger these blood cofactors which influence in varying ways sometimes causing clots while at the same time causing hemmorages or anemia.

The body chemistry is very complex.

Four studies found that AMD was associated with increased rates of sleep apnea and poorer reported sleep quality, while five studies showed that patients with sleep apnea or insomnia were at higher risk of developing AMD.

Knowing that fasting reduced hypoxia due to the decrease of CO2 production in the mitochondria during the Krebs Cycle production of ATP, I wondered if fasting decreased AMD by reducing hypoxia in the eyes.

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