Affiliation:
1. Department of Ophthalmology University of Kiel, University Medical Center of Schleswig‐Holstein Kiel Germany
2. Institute of Biomedical Optics, University of Luebeck Luebeck Germany
3. Department of Ophthalmology University of Luebeck, University Medical Center of Schleswig‐Holstein Luebeck Germany
4. Eye Clinic Sulzbach, Knappschaft Hospital Saar Sulzbach Germany
5. Department of Ophthalmology University of Pittsburgh Pittsburgh Pennsylvania USA
6. Hannover Medical School University Eye Clinic Hannover Germany
7. Medical Laser Center Luebeck Luebeck Germany
Abstract
ABSTRACTObjectivesNumerous laser and light therapies have been developed to induce regenerative processes in the choroid/retinal pigment epithelium (RPE)/photoreceptor complex, leaving the neuroretina undamaged. These therapies are applied to the macula for the treatment of various diseases, most prominently diabetic maculopathy, retinal vein occlusion, central serous chorioretinopathy, and age‐related macular degeneration. However, the abundance of technologies, treatment patterns, and dosimetry protocols has made understanding these therapies and comparing different approaches increasingly complex and challenging. To address this, we propose a new nomenclature system with a clear categorization that will allow for better understanding and comparability between different laser and light modalities. We propose this nomenclature system as an open standard that may be adapted in future toward new technical developments or medical advancements.MethodsA systematic literature review of reported macular laser and light therapies was conducted. A categorization into a standardized system was proposed and discussed among experts and professionals in the field. This paper does not aim to assess, compare, or evaluate the efficacy of different laser or dosimetry techniques or treatment patterns.ResultsThe literature search yielded 194 papers describing laser techniques, 50 studies describing dosimetry, 272 studies with relevant clinical trials, and 82 reviews. Following the common therapeutic aim, we propose “regenerative retinal laser and light therapies (RELITE)” as the general header. We subdivided RELITE into four main categories that refer to the intended physical and biochemical effects of temperature increase (photothermal therapy, PTT), RPE regeneration (photomicrodisruption therapy, PMT), photochemical processes (photochemical therapy, PCT), and photobiomodulation (photobiomodulation therapy, PBT).Further, we categorized the different dosimetry approaches and treatment regimens. We propose the following nomenclature system that integrates the most important parameters to enable understanding and comparability:Pattern—Dosimetry—Exposure Time/Frequency, Duty Cycle/Irradiation Diameter/Wavelength—Subcategory—Category.ConclusionRegenerative retinal laser and light therapies are widely used for different diseases and may become valuable in the future. A precise nomenclature system and strict reporting standards are needed to allow for a better understanding, reproduceable and comparable clinical trials, and overall acceptance. We defined categories for a systematic therapeutic goal‐based nomenclature to facilitate future research in this field.