Exposure of the retina to subthreshold micro- and nanosecond laser at early stages of age-related macular degeneration

Abstract

At the moment, there are no effective methods of treatment for age-related macular degeneration at its early stages. The perspective of treatment for age-related macular degeneration may be a method using subthreshold laser radiation. In the present review of literature, analysis is represented of using both subthreshold micro- and nanosecond laser radiation on the retina in intermediate AMD stage. Subthreshold diode micro-pulse laser exposure of the retina in AMD has proven to be a safe procedure that allows for the regression of macular drusen. While some authors noted an improvement in visual functions and a decrease in the probability of developing choroidal neovascularization with such treatment, multicenter trials have not yet confirmed the effectiveness of micro-pulse therapy as a method to prevent the neovascular AMD development. Subthreshold nanosecond laser impact on the retina is safe for the structures of the eye fundus, theoretically more selective stimulates the natural biological and regenerative potential in the pigment epithelium and neuroepithelium due to remodeling of extracellular matrix, restores the thickness of the Bruchs membrane and metabolism between external retinal layers and choriocapillaris. Encouraging results have been achieved from the use of nanopulse therapy as a method of preventing the development of advanced stage AMD in the absence of reticular pseudodrusen, however, it seems premature to recommend this technology for widespread clinical use - further research is needed. The prospects of invading in wide clinical practice of subthreshold nanosecond laser impact on the intermediate stage of AMD on the basis of the obtained clinical research results are encouraging (regression of drusen, preventing of AMD progression in absence of reticular pseudodrusen), but there is currently no evidence base. It is required to conduct further researches.