Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, University of Melbourne, East Melbourne, Australia.
Clin Exp Ophthalmol. 2014 Jul;42(5):466-79. doi: 10.1111/ceo.12247. Epub 2013 Nov 11.
A novel, ultra-low energy nanosecond laser (retinal rejuvenation therapy) has been developed with the aim to slow progression of early age-related macular degeneration (AMD). The safety, changes in fundus characteristics and macular function in a cohort of participants with bilateral intermediate AMD are reported.
Prospective non-randomised, pilot intervention study.
Subjects with bilateral intermediate AMD (n = 50, aged 50-75 years).
Ultra-low energy laser pulses applied in 12 spots around the macula of one eye (0.15-0.45 mJ), using 400 μm diameter spot, 3 nanosecond pulse length, 532 nm wavelength and energy titrated to each patient.
Best corrected visual acuity, drusen area and macular sensitivity (flicker perimetry) at baseline and at 3, 6 and 12 months post-laser.
Treatment was painless with no clinically visible lesions. No participant developed choroidal neovascularization, while two with thin central retinal thickness at baseline developed atrophy at 12-month follow up. Drusen area was reduced in 44% of treated eyes and 22% of untreated fellow eyes, with changes in drusen and function not being coincident. Improvement in flicker threshold within the central 3° was observed in both the treated and untreated fellow eyes at 3 months post-laser. Of the 11 eyes at greatest risk of progression (flicker defect >15 dB), seven improved sufficiently to be taken out of this high-risk category.
A single unilateral application of nanosecond laser to the macula produced bilateral improvements in macula appearance and function. The nanosecond retinal rejuvenation therapy laser warrants ongoing evaluation as an early intervention for AMD.
一种新型超低能量纳秒激光（视网膜 rejuvenation 治疗）已被开发出来，旨在减缓早期年龄相关性黄斑变性（AMD）的进展。本研究报告了一项针对双侧中间期 AMD 患者的安全性、眼底特征和黄斑功能变化的前瞻性非随机干预研究结果。
前瞻性非随机干预研究。
双侧中间期 AMD 患者（n=50，年龄 50-75 岁）。
在一只眼的黄斑周围的 12 个点应用超低能量激光脉冲（0.15-0.45 mJ），使用 400μm 直径光斑，3 纳秒脉冲长度，532nm 波长，能量根据每个患者进行滴定。
治疗前、治疗后 3、6 和 12 个月时的最佳矫正视力、玻璃膜疣面积和黄斑敏感性（闪烁视敏度）。
治疗无痛苦，无肉眼可见的病变。没有患者发生脉络膜新生血管化，而两名基线时视网膜中央厚度较薄的患者在 12 个月随访时发展为萎缩。治疗眼的玻璃膜疣面积减少了 44%，未治疗的对侧眼减少了 22%，玻璃膜疣和功能的变化并不一致。治疗后 3 个月，治疗眼和未治疗眼的中央 3°闪烁阈值均有改善。在最易进展的 11 只眼中（闪烁缺陷>15dB），有 7 只眼的改善足以使其脱离高风险类别。
单次单侧应用纳秒激光治疗黄斑，可使黄斑外观和功能双侧均得到改善。纳秒视网膜 rejuvenation 治疗激光值得进一步评估，作为 AMD 的早期干预手段。
