The non-invasive approach to the patient.
The treatment of AMD and many macular diseases, which can severely impair central vision, has undergone a revolution in the last decade due to the increasing use of intra-vitreal therapies.
However, for the dry (non-vascular) form of AMD and also for serious diseases such as diabetic retinopathy and its dreaded complication, diabetic macular oedema, or for central serous chorioretinitis, other approaches should also be considered.
Let's consider, first of all, a novelty from the world of nanotechnology, the Laser 2RT (Ellex), presented in September 2015 at the ESCRS congress and about which Dr Eugenio Sancin, ophthalmologist at the Eye Care centre in Trieste, tells us.
What is the 2RT laser?
This is a retinal laser that, compared to conventional photocoagulant lasers, acts on the retina with a photostimulating effect. Treatment with the 2RT laser, also known as Retinal Rejuvenation Therapyis a non-invasive procedure that stimulates a natural biological response of the treated retina to stop MSDs. This is possible thanks to the application of very short laser pulses lasting 3 nanoseconds, which do not damage the neuroretina.
How effective is the 2RT laser?
Clinical studies have shown that the application of 2RT laser light can provide both a functional improvement of the retina and a regression of drusen, the first alterations of maculopathy present in the early and intermediate stages (see bibliographical references).
How is treatment with the 2RT laser carried out?
Being a non-invasive procedure, the treatment is performed on an outpatient basis. After dilating the pupil, very short pulses of sub-threshold energy laser light are applied to the retina: the procedure takes only a few minutes and is completely painless. Each patient is carefully assessed clinically and instrumentally, with OCT examination and above all microperimetry, a sophisticated functional examination, which is essential for assessing the indication for the 2RT laser and its effectiveness. The 2RT laser has proven to be an extremely safe and effective procedure, with no adverse effects reported to date. Of course, it must be performed at qualified centres. In most cases, one procedure is sufficient, or can be repeated after six months if necessary.
For which other pathologies is the 2RT laser indicated?
In addition to DMS, the new 2RT laser is also indicated for the treatment of diabetic retinopathy with macular oedemabut can also be used for other pathologies, such as macular oedema from venous occlusion or the central serous chorioretinitisThe results we have obtained are very satisfactory, and often without having to resort to intravitreal injections or much more invasive conventional laser treatments.
In combination with the laser approach, as adjuvant therapy, or as the only non-invasive approach, the nutritional therapybased on the supplementation of certain substances that are essential for the health of the retina.
These include Lutein, Zeaxanthin, Astaxanthin, Omega 3, Vitamins C and E, e.g. contained in Azyr Mega (SIFI).
In the case of intravitreal treatment, the action of anti-VEGF drugs can be supported with specifically formulated nutraceuticals based on plant extracts, carotenoids and minerals, such as AVS Retina (SIFI).
Bibliography
- Jobling AI et al. Nanosecond Laser Therapy Reverses Pathologic and Molecular Changes in Age-Related Macular Degeneration without Retinal Damage. The FASEB Journal 29, no. 2 (February 1, 2015): 696-710.
- Zhang JJ, Sun Y, Hussain AA, Marshall J. Laser mediated activation of human retinal pigment epithelial (RPE) cells and concomitant release of matrix metalloproteinases (MMPs). Invest Ophthalmol Vis Sci. 2012 May 17;53(6):2928-37. doi: 10.1167/iovs.11-8585
Dr. Carmelo Chines
Direttore responsabile
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