Laser therapy ophtalmology, macula degeneration

Low-Level Laser Therapy Improves Visual Acuity in Adolescent and Adult Patients with Amblyopia

Boris T. Ivandic, M.D.,1 and Tomislav Ivandic, M.D. 2

Objectives: The purpose of this study was to examine the effects of low-level laser therapy (LLLT) on visual acuity in adolescent and adult patients with amblyopia.

Background Data: Currently, amblyopia can be treated successfully only in children.

Methods: In this single-blinded, placebo-controlled study, 178 patients (mean age 46.8 years) with amblyopia caused by ametropia (110 eyes) or strabismus (121 eyes) were included.

For LLLT, the area of the macula was irradiated through the conjunctiva from 1 cm distance for 30 sec with laser light (780 nm, 292 Hz, 1:1 duty cycle; average power 7.5mW; spot area 3mm2). The treatment was repeated on average 3.5 times, resulting in a mean total dose of 0.77 J/cm2. No occlusion was applied, and no additional medication was administered. Best corrected distant visual acuity was determined using Snellen projection optotypes. In 12 patients (12 eyes), the multifocal visual evoked potential (M-VEP) was recorded. A control group of 20 patients (20 eyes) received mock treatment.

Results: Visual acuity improved in *90% of the eyes treated with LLLT ( p < 0.001), increasing by three or more lines in 56.2% and 53.6% of the eyes with amblyopia caused by ametropia and strabismus, respectively. The treatment effect was maintained for at least 6 months. The mean M-VEP amplitude increased by 1207 nV ( p < 0.001) and mean latency was reduced by 7msec ( p = 0.14). No changes were noted in the control group.

Conclusion: LLLT led to a significant improvement in visual acuity in adolescent and adult patients with amblyopia caused by ametropia or strabismus.

Photomedicine and Laser Surgery Volume 26, Number 3, 2008

Low-Level Laser Therapy Improves Vision in Patients with Age-Related Macular Degeneration

Boris T. Ivandic, M.D.,1 and Tomislav Ivandic, M.D.2

Objectives: The objective of this study of a case series was to examine the effects of low-level laser therapy (LLLT) in patients with age-related macular degeneration (AMD).

Background Data: AMD affects a large proportion of the elderly population; current therapeutic options for AMD are limited, however.

Methods: In total, 203 patients (90 men and 113 women; mean age 63.4 5.3 y) with beginning (�dry�) or advanced (�wet�) forms of AMD (n  348 eyes) were included in the study. One hundred ninetythree patients (mean age 64.6 4.3 y; n  328 eyes) with cataracts (n  182 eyes) or without cataracts (n  146 eyes) were treated using LLLT four times (twice per week). A semiconductor laser diode (780 nm, 7.5 mW, 292 Hz, continuous emission) was used for transconjunctival irradiation of the macula for 40 sec (0.3 J/cm2) resulting in a total dose of 1.2 J/cm2. Ten patients (n  20 eyes) with AMD received mock treatment and served as controls. Visual acuity was measured at each visit. Data were analyzed retrospectively using a t-test.

Results: LLLT significantly improved visual acuity (p  0.00001 versus baseline) in 162/182 (95%) of eyes with cataracts and 142/146 (97%) of eyes without cataracts. The prevalence of metamorphopsia, scotoma, and dyschromatopsia was reduced. In patients with wet AMD, edema and bleeding improved. The improved vision was maintained for 3�36 mo after treatment. Visual acuity in the control group remained unchanged. No adverse effects were observed in those undergoing therapy.

Conclusion: In patients with AMD, LLLT significantly improved visual acuity without adverse side effects and may thus help to prevent loss of vision.



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