Photobiomodulation in the treatment of patients with non-center-involving diabetic macular oedema

Abstract

Purpose Far-red/near-infrared phototherapy or photobiomodulation (PBM) has recently been reported to be an effective and non-invasive treatment method to inhibit lesions of diabetic retinopathy (DR) in animals. This study investigated the safety and efficacy of PBM in diabetic patients to treat non-center-involving diabetic macular oedema (NCDME). Methods This was a non-randomised, consecutive, case series, where 4 patients with type 2 diabetes with NCDME were treated for 160 s per day with PBM for 2–9 months. Demographic data including age, sex, HbA1c%, electronic ETDRS visual acuity, and retinal and macular thickness were measured using spectral domain ocular coherence tomography (SD-OCT) before and after treatment. Results Four eyes of 4 patients were treated, with fellow eyes serving as untreated controls. Daily PBM treatment for only 80 s per treatment twice daily caused a significant reduction in focal retinal thickening in all 4 treated eyes. No adverse effects attributable to therapy were noted by the patients or study investigators during the study period. Conclusions PBM potentially offers a non-invasive and cost-effective therapeutic option for patients with NCDME. Further studies of this therapeutic option in DR are warranted

Mechanistic Insights into Pathological Changes in the Diabetic Retina

“…89e92 Studies related to the retina likewise have demonstrated that the low-intensity far-red (670 nm) light treatment mitigates pathology in retinal degeneration models 93,94 and, recently, also in DR. 95,96 In both diabetic albino rats 96 and pigmented mice, 97 whole-body exposure to far-red light (670 nm) for only 4 minutes per day from the onset of diabetes or as an intervention mitigated abnormalities that are believed to contribute to DR, including increased generation of superoxide, induction of a local proinflammatory environment, and dysfunction or degeneration of retinal neurons. Consistent with this, daily photobiomodulation administered to a small series of diabetic patients having nonecenterinvolved macular edema was associated with the gradual reduction in retinal thickness.…”

“…Consistent with this, daily photobiomodulation administered to a small series of diabetic patients having nonecenterinvolved macular edema was associated with the gradual reduction in retinal thickness. 95 Arden et al 98 likewise used light to exert a beneficial effect on DME. In one study, they used trans-eyelid retinal illumination of one eye in patients with DR during sleep throughout a 3-month period, and found a reduction in the number of hemorrhages and microaneurysms compared to the contralateral eyes.…”

Do photoreceptor cells cause the development of retinal vascular disease?

“…Animal studies using albino rats and pigmented mice showed that whole-body photobiomodulation inhibited diabetes-induced abnormalities in retinal oxidative stress, inflammation, and electroretinogram [31,38], and very effectively inhibited diabetes-induced increases in capillary degeneration and accumulation of albumin in neural retina (unpublished). In a case report series of diabetic patients having non-center involved retinal edema, application of the same wavelength of light for an equally short interval daily showed beneficial effects to reverse the edema in the treated eye [39]. …”

Photobiomodulation reduces drusen volume and improves visual acuity and contrast sensitivity in dry age‐related macular degeneration

“…Further, PBM has recently been shown to reduce non‐central diabetic macular oedema in a case series (Tang et al. 2014). …”