4.7 Review

Subthreshold Nano-Second Laser Treatment and Age-Related Macular Degeneration

Journal

JOURNAL OF CLINICAL MEDICINE
Volume 10, Issue 3, Pages -

Publisher

MDPI
DOI: 10.3390/jcm10030484

Keywords

drusen; age-related macular degeneration; laser

Funding

  1. National Health & Medical Research Council of Australia [APP1027624, GNT1103013, APP1104985, APP1054712, APP1142962, GNT1128343]
  2. BUPA Health Foundation (Australia)
  3. Ellex R&D Pty Ltd. (Adelaide, Australia)
  4. CERA, an independent medical research institute

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This article summarizes the potential of lasers in slowing the progression of AMD and key findings from clinical trials, while also highlighting the importance of advances in multimodal imaging and functional testing, as well as ongoing investigation of key pathological mechanisms in further exploring the utility of nanosecond and other subthreshold short pulse lasers in AMD.
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.

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