J.ophthalmol.(Ukraine).2016;5:22-27.

Changes in visual acuity in patients with dry form of age-related macular degeneration after low-energy light therapy and medication 

A.M. Sergienko 1, Dr. Sc. (Med.), Prof.

N.O. Dzyuba 2, MD 

1 Professor Sergienko`s Eye Clinic, Vinnitsa, Ukraine

2 Kyiv city center of the diagnosis and treatment of vascular degenerative eye diseases, Kyiv city clinical hospital № 9, Kyiv, Ukraine

 

Introduction. Age-related macular degeneration (AMD) leads to partial or complete loss of central vision, causing disability of patients. The current problem explains completely the search for new methods of influence on the visual analyzer in patients with AMD. 

The рurpose. To study the changes in visual acuity in patients with the dry form of AMD after two courses of low-energy light therapy and medication. 

Material and methods. Study Group was made up of 115 patients (187 eyes), which took two courses of low energy light therapy (LELT) in combination with two courses of medication in the hospital for 10 days each. Control Group consisted of 95 patients (163 eyes), which passed only two courses of medication in the hospital for 10 days each. Time points of follow up were before treatment (baseline), after treatment, 1, 3, and 6 months after the first course of treatment. Afterwards, the second treatment course was performed with the same time points. Visual acuity testing was performed using ETDRS tables (number of characters). Depending on the visual acuity (VA), Study Group was divided as follows: Subgroup I, 54 eyes ≤ 47 fig.; Subgroup II, 133 eyes > 47 fig. Control Group: Subgroup I, 47 eyes ≤ 47 fig.; Subgroup II, 116 eyes > 47 fig. 

Results and their discussion. After completing two courses of treatment,VA rate improvement was by 21.6% better in Study Subgroup I patients than in Control Subgroup I ones, i.e. (22 eyes (40.7%) vs. 9 eyes (19.1%), respectively; VA rate stabilization was noted in 6 eyes (11.1% cases) of Study Subgroup I patients. Overall, treatment was more successful by 32.7% in Study Group as compared with Control Group, i.e. 28 eyes (51.8%) vs. 9 eyes (19.1%), respectively. Decrement in VA rates was less by 32.8% in Study Group than in Control Group, i.e. 26 eyes (48.1 %) vs. 38 eyes (80.9 %), respectively.  After completing two courses of treatment in patients of Study and Control Subgroups II, VA improvement rates were higher by 79.8% in Study Group patients than in those of Control Group, i.e. 113 eyes (85.0%) vs. 6 eyes (5.2%), respectively; VA stabilization rates were higher by 4.6% in Control Group patients than in those of Study Group, i.e. 15 eyes (12.9%) vs. 11 eyes (8.3%), respectively. Overall, treatment success was higher by 75.2% in Study Group than in Control one, i.e. 124 eyes (93.3%) vs. 21 (18.1%), respectively. 

Conclusions. 1.It was found that AMD patients with low vision had stabilization of VA rates (pre-treatment (28.6±1.0) figures, post-treatment (28.7±1.1) figures, р=0.496) after two joint courses of low-energy light therapy and medication; meanwhile, patients receiving medication only therapy had significant decrement in visual acuity from (29.3±1.0) to (26.2±1.2) figures (р=0.000). 2.It was revealed that, after two joint courses of low-energy light therapy and medication, AMD patients with high VA rates had significant increase of VA rates from (71.4±0.8) figures at baseline to (76.6±0.9) figures at 12 months, (р=0.000); while VA rates decreased from (69.5±0.9) to (66.3±0.9) (р=0.000), respectively, in patients receiving medication only therapy. 3.It was noted that treatment of AMG patients both with poor and high VA rates who underwent two joint courses of low-energy light therapy and medication was more successful than in those who received two courses of medication only therapy. The difference between them was 32.7% (14.0 ÷ 48.15. р=0.001) for poor VA rates and 75.2% (65.4 ÷ 81.9, р<0.000) for high VA rates.4.Success of low-energy light therapy in combination with medication course in AMD patients depends on baseline VA rates: the higher visual acuity is, the more successful is the treatment. 

Key words: vision acuity, low-energy light therapy, medication, age-related macular degeneration

 

References

1.Bibkov MM, Faizrakhmanov RR, Yarmukhametova. [Age-related macular degeneration]. M.: Aprel; 2013. 196p. Russian. 

2.Venger LV. [Efficacy of potostimulation with monochromatic pulsed light in restorative treatment of amblyopia patients]. Odeskii Med. Zhurnal. 2001;3:82-6. Ukrainian. 

3.Yevsyukova O. [Local immunity changes in patients with dry form of age-related macular degeneration]. Oftalmologiia. Vostochnaia Evropa. 2014;2(21):41-7. Russian. 

4.Egorov EA, Romanenko IA. [Age – related macular degeneration]. KOFT. 2009;1:42-5. Russian.   

5.Karliychuk M. [Role of combined nutraceuticals in the prevention of development and progression of age-related macular degeneration]. Oftalmologiia. Vostochnaia Evropa. 2014;2(21):139-49. Russian.  

6.Kryzhanovska TV. [Disability due to eye pathology in the population of Ukraine in the years 90-2002]. Oftalmol Zh. 2003;3:23-7. Ukrainian.  

7.Kryzhanovska TV. [State and topical issues of prevention of blindness and hypovision in Ukraine]. Oftalmol Zh. 2002;6:67-70. Ukrainian. 

8.Kuliakin MI, Parameĭ VT, Kliutsevaia EI, Savostenko IG. [Phototherapy of high complicated myopia]. Oftalmol Zh. 1981;36(4):228-31. Russian. 

9.Kuliakin MI, Kliutsevaia EI, Parameĭ VT, Savostenko IG. [Phototherapy of partial optic atrophy]. Oftalmol Zh. 1982;37(3):159-62. Russian. 

10.Logai IM, Sergienko NM, Kryzhanovska TV. [Blindness and hypovision in Ukraine and current issues of their prevention.] X Congress of Ophthalmologists of Ukraine: Thesis. 28-30 May 2002. Odessa: 2002. 10-11. Russian. 

11.Marchenkova TE, Mironova EM, Golubtsov KV, Arnoldova AV. [Application of chromatic pulse photostimulation for treatment  of retinal and optic nerve pathology]. Oftalmol Zh. 2006;3:27-30. Russian. 

12.Nagorna AM, Rykov SO, Varyvonchyk DV. [State of eye morbidity of population in Ukraine]. Ophtalmol Zh. 2003; 3:28-33. Ukrainian. 

13.Pasechnikova NV, Korol AR, Zadorozhny OE, Kustrin TB, Nasinnik IO. [Modern principles of diagnosis and treatment of age-related macular degeneration]. Oftalmol Zh. 2013;4:93-107. Ukrainian. 

14.Petrunya A. M., Yevsyukova O. A. [Influence of immunotropic drugs on humoral immunity in patients with a dry form of age-related macular degeneration]. Oftalmol Zh. 2013;2:43-7. Russian. 

15.Scrypnyk R, Scripnichenko I. [Prophylactics and treatment of age-related macular degeneration]. Oftalmologiia. Vostochnaia Evropa. 2014;1(20):100-3. Russian.   

16.Soldatova AM. [The role of free radical oxidation-reduction processes and visible light in the pathogenesis of sclerotic macular degeneration and its differentiated treatment]. Author’s thesis for Dr. Of Med. Sc.: 14.00.18. Filatov Institute of Eye Diseases and Tissue Therapy. Odessa; 1992. 36p. Russian. 

17.Shargorodska IV. [Effect of monochromatic light on hydrodynamics of the eye]. Author’s thesis for Cand. Of Med. Sc.: 14.00.18.  Shupyk National Medical Academyof Postgraduate Education. K.; 2003. 19p. Ukrainian. 

18.Camparini M, Cassinari P, Ferrigno L. et al. ETDRS–Fast: Implementing Psychophysical Adaptive Methods to Standardized Visual Acuity Measurement with ETDRS Chart. Inv. Ophthalmol. Vis. Sc. 2001; May 42(6):1226–31.

19.Vanden Bosh ME, Wall M. Visual acuity scored by the letter-by-letter or probit methods has lower retest variability then the line assignment method. Eye. 1997;11(3):411–7.