Photobiomodulation: What is it?
Photobiomodulation (PBM) is simply the manipulation of cellular behavior using low intensity light sources. The scientific basis for this phenomenon is well established, but still only partially understood. Basically, certain wavelengths of light at relatively low energy levels effect cell metabolism in specific ways. Cellular effects are determined by variables such as the wavelength of the light, the intensity (energy density), the coherency of the light, and the exposure time.
History of Photobiomodulation
The history of using light and color for health and healing can be traced thousands of years back in human history. Virtually all ancient civilizations (China, India, Egypt, Greece, Meso-America) implemented the use of sunlight or colored light in healing. The nineteenth century saw a resurgence of this concept with the use of colored light sources for the promotion of wound healing and pain reduction.
In 1903, Dr. Niels Finsen (Denmark) received the Nobel Prize in Medicine “In recognition of his contribution to the treatment of diseases, …with concentrated light radiation whereby he has opened a new avenue for medical science.” Though his pioneering work was eclipsed by the advent of the pharmaceutical industry in the early third of the century, the latter half of the 1900’s witnessed a rediscovery of the science by researchers like Gürwitsch (Russia), Mester (Hungary), Karu (Russia), Frölich and Popp (Germany). There are now more than forty years of formal research papers available in the area of PBM.
What We Know
From decades of research, we now know numerous facts about PBM effects. The mechanisms by which these varied biological effects occur are explained by a mixture of recognized photo biochemical reactions and poorly understood quantum energy effects.
Specific genes can be selectively up or down-regulated (switched on or off). One can, for instance, suppress inflammation, effect metabolic rates, effect cell proliferation, and block cell death. Additionally, specific light sequences can cause cell regeneration and revitalization, new blood vessel growth or suppression, and new collagen formation.
Appropriate light codes have also been shown to be protective against a wide array of toxins (chemical, ionizing, and bacteriologic). Studies confirm systemic endocrine and mentation (mood, seasonal affective, and sleep disorders) effects from light exposure, while others show significant reductions in healing times (50-80%) and increased wound strength.
Ophthalmic Applications of PBM
Various commercial phototherapy devices have been FDA approved for non-ophthalmic aesthetic (cosmetic), wound healing, and pain reduction applications. These instruments are usually built around light-emitting diode (LED) arrays, but some also utilize low power lasers or halogen light sources to produce the desired light code. Most such devices emit in the red to near infra-red but some also extend into the blue end of the spectrum. Dr. Dotson has designed and produced numerous prototypes of LED-based light sources for use in his own practice.
Dr. Dotson was the first eye surgeon to use such devices in an “off-label” fashion for ophthalmic specific applications. This therapy has now become an integral part of his practice and it is used everyday for eye healing.
After months of literature reviews and much discussion between Drs. Dotson, Merry and Devenyi the first clinical trial of Photobiomodulation utilizing Light Emitting Diodes (LED’s) for dry AMD was designed. The pilot study was designed to look for efficacy to those patients with dry AMD by assessing Visual Acuity (ETDRS), contrast sensitivity and fixation stability (using the NidekMP1 Perimeter).
The TORPA study results were positive and Dr. Merry has since treated over 120 eyes “off label”.
Some of the off label data has been retrospectively studied and presented at major international ophthalmology conferences such as ARVO 2016 in Seattle and EURETINA 2016 in Copenhagen.
We are very excited and pleased to announce that this data has now been published in ACTA OPHTHALMALOGICA, a high impact peer reviewed ophthalmology journal.
PBM is starting to gain recognition as an emerging treatment for dry AMD and has been mentioned in presentations at EURETINA 2016 and just recently at The Inaugural World Retina Congress held in Fort Lauderdale 2017.