New Treatment Options for AMD

AMD is the leading cause of your reversible vision loss in Europe, the United States, and Canada. It is a disease almost always occurring in the over 50 age group. While it can progress at a different rate from patient to patient, too frequently it results in great impairment or complete loss of central vision, leaving patients unable to read, see faces or perform visual tasks. Its cause is complex and not fully understood, but certain factors significantly increase the risk of vision loss. These are:

  • Age over 60
  • Family history of AMD
  • Cigarette smoking
  • Poor diet, particularly deficient in green vegetables and fruit
  • Obesity
  • Hypertension
  • Blue or green eyes with fair complexion
  • High exposure to bright (particularly blue) light.
Macular degeneration is characterized by the accumulation of pale waste products or drusen from the vision cells as shown, and these can be reduced with the 2RT laser.

AMD affects the central retinal, or macula which is loaded with vision cells, the photoreceptors. These cells need to receive nutrition and oxygen from the underlying blood vessels in the choroid, and they also produce waste products need to be eliminated. The caretaker cells that regulate these functions, the retinal pigment epithelial cells (RPE), progressively fail in AMD. Their failure results in accumulation of these waste products, or drusen, and progressive loss of the ability to transport nutrients and oxygen to the photoreceptors, impairing their function and ultimately causing their death.

AMD can progress from gradually increasing accumulation of these waste products with accompanying slow decline in vision to one of two potentially catastrophic outcomes of Late AMD, Geographic Atrophy or Neovascular AMD. GA represents permanent death of the photoreceptors. Neovascular (or “wet”) AMD results when the waste deposits result in a breakdown of the barrier separating the retina from the blood vessel rich adjacent layer, the choroid, permitting the ingrowth of new vessels that can leak and bleed into the retina with very damaging consequences for vision.

Treatment for early and advancing AMD to prevent end stage progression

Actual treatment using the 2-RT Laser

The 2RT laser uses very low energy and short duration laser pulses to stimulate production of new and rejuvenated RPE cells and these cells are then more cable of performing their functions of clearing waste products and enhancing the nutrition and oxygen delivery to photoreceptors.

There is now strong evidence that 2RT laser treatments can improve visual functioning that they greatly reduce the likelihood of early or intermediate AMD progressing to Late (and potentially blinding) AMD. Patients with Late AMD or those transitioning into Late AMD may be be helped with 2RT, but its usefulness in such patients is hard to ascertain. By that stage much irreversible damage may have already occurred, and some further progression is likely unavoidable. However, 2RT may still be helpful in limiting the extent of destruction of macular cells. Preserved healthy areas of macula may then be used for optimizing remaining vision with other methods such as Clear-K laser treatment.

Treatment of advanced vision loss from AMD

AMD can unfortunately lead to profound visual loss, resulting in an inability to read, operate a motor vehicle or identify facial features. We have never had more to offer to these patients than magnification and navigation tools. Magnification can modestly improve visual discrimination, but it does so by creating disabling tunnel vision. A new laser is now showing promise in improving vision without resorting to magnification.

The Clear-K laser uses a process of photovitrification (localized hardening without loss of clarity) to alter the optics of the cornea in order to disperse light around the macula, allowing functioning retina just eccentric to the macular centre to receive well-focused light. This entrains these paracentral areas to provide more high quality vision. Many patients have been able to recover several lines of vision on the vision chart, dramatically improving their ability to function visually.

commentary on 2RT by Prof. Jon Marshall, Emeritus Professor of Ophthalmology at King’s College London – Click HERE


Payment for the 2RT and Clear-K laser treatments is not covered by the Medical Services Plan. Patients may pay by either cash or credit card at the time of treatment. A receipt for income tax purposes will be issued and no GST is applicable.