Cohn Amy C, Wu Zhichao, Jobling Andrew I, Fletcher Erica L, Guymer Robyn H
Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, Melbourne 3002, Australia.
Department of Ophthalmology, Department of Surgery, The University of Melbourne, Parkville 3052, Australia.
J Clin Med. 2021 Jan 28;10(3):484. doi: 10.3390/jcm10030484.
The presence of drusen is an important hallmark of age-related macular degeneration (AMD). Laser-induced regression of drusen, first observed over four decades ago, has led to much interest in the potential role of lasers in slowing the progression of the disease. In this article, we summarise the key insights from pre-clinical studies into the possible mechanisms of action of various laser interventions that result in beneficial changes in the retinal pigment epithelium/Bruch's membrane/choriocapillaris interface. Key learnings from clinical trials of laser treatment in AMD are also summarised, concentrating on the evolution of laser technology towards short pulse, non-thermal delivery such as the nanosecond laser. The evolution in our understanding of AMD, through advances in multimodal imaging and functional testing, as well as ongoing investigation of key pathological mechanisms, have all helped to set the scene for further well-conducted randomised trials to further explore potential utility of the nanosecond and other subthreshold short pulse lasers in AMD.
玻璃膜疣的存在是年龄相关性黄斑变性（AMD）的一个重要标志。激光诱导玻璃膜疣消退，这在四十多年前首次被观察到，引发了人们对激光在减缓该疾病进展中潜在作用的浓厚兴趣。在本文中，我们总结了临床前研究的关键见解，这些见解涉及各种激光干预措施在视网膜色素上皮/布鲁赫膜/脉络膜毛细血管界面产生有益变化的可能作用机制。还总结了AMD激光治疗临床试验的关键经验教训，重点关注激光技术向短脉冲、非热传递（如纳秒激光）的发展。通过多模态成像和功能测试的进展，以及对关键病理机制的持续研究，我们对AMD认识的演变，都为进一步开展精心设计的随机试验奠定了基础，以进一步探索纳秒激光和其他亚阈值短脉冲激光在AMD中的潜在效用。
