Abstract
Purpose :
Several laser and light therapies act on the choroid/retinal pigment epithelium (RPE)/photoreceptor complex, leaving neuroretina undamaged. The abundance of different laser modalities, treatment patterns and dosing protocols, make a standardization difficult. We propose a new nomenclature that will enable a better understanding and comparability of different laser and light therapies.
Methods :
A systematic literature review of reported macular laser and light therapies, and discussions among experts and professionals in the field were conducted. Application methods were categorized into a standardized system based on their mechanisms of actions.
Results :
Among the literature about neuroretina-sparing laser or light therapies, 162 papers on laser techniques, 49 on dosimetry, 258 on clinical trials and 79 reviews were found. Following the common therapeutic aim, we propose “retina regenerative laser and light therapies (RELITE)” as general header. We subdivide RELITE into 4 main subcategories that refer to the intended physical and biochemical effects of temperature increase (photothermal laser therapy, PTL), RPE rejuvenation (photodisruptive laser therapy, PDL), photochemical processes (photochemical laser therapy, PCL) and photobiological modulations (photobiological light therapy, PBL). The different irradiation techniques to achieve this were given three-letter-codes, most of them have been reported before.
PTL techniques are “thermal stimulation of the retina (TSR)”, “non-damaging retinal therapy (NRT)”, “micro-second laser therapy (MLT)”, and “transpupillary thermal therapy (TTT)”.
PDL tehniques are “selective retina therapy (SRT)” and “retinal rejuvenation therapy (2RT)”.
PCL can be achieved by “photodynamic therapy (PDT)” and PBL by “retinal photobiomodulation (PBM)”.
Further, we identified an abundance of technical specifications. We propose the following formula that integrates the most reported and needed parameters to enable understanding and comparability:
Pattern –– Irradiation – Dosing – Subcategory – Category
Conclusions :
RELITE may evolve to an important ophthalmic therapy. We defined categories for a systematic therapeutic goal-based nomenclature. A precise nomenclature system and strict reporting standards are needed to allow for a better understanding, reproduceable comparable clinical trials and overall acceptance.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.