Objective:

To evaluate the efficacy and safety of photobiomodulation (PBM) for treating dry age-related macular degeneration (AMD) following FDA authorization, which has significant implications for clinical practice.

Key Findings:

• PBM group showed a statistically significant improvement in BCVA compared to sham at 13 months (mean gain of 5.4 letters vs 3.0 letters, P=.02).
• At 24 months, the PBM group gained a mean of 5.9 letters while the sham group gained 1.0 letter (P value needed).
• No significant change in drusen volume was observed in the PBM group, while an increase was noted in the sham group (0.049 mm3).
• New geographic atrophy (GA) occurred significantly less in the PBM group (1 of 87 eyes) compared to the sham group (5 of 50 eyes, P=.024).

Interpretation:

While PBM shows promise in improving visual acuity in dry AMD, the clinical significance of the improvements is questioned due to small absolute gains and potential natural variability in vision, which may limit its applicability in practice.

Limitations:

• Concerns about the small sample size and potential regression to the mean affecting results.
• The sham group was older and had worse baseline vision, which may influence outcomes, raising questions about the comparability of groups.

Conclusion:

Further research is needed to confirm the efficacy and safety of PBM for dry AMD, particularly focusing on long-term outcomes and potential side effects, and clinicians should consider these findings cautiously before integrating PBM into treatment protocols.