Photobiomodulation-induced choriocapillaris perfusion enhancement and outer retinal remodelling in intermediate age-related macular degeneration: a promising therapeutic approach with short-term results

Purpose: To evaluate the effects of photobiomodulation (PBM) on choriocapillaris (CC) perfusion and drusen volume in patients with intermediate age-related macular degeneration (AMD). Methods: In this retrospective pilot study, 30 patients receiving PBM therapy and 30 age-matched controls were analysed. Treatment consisted of 8 sessions over 4 weeks using the EYE-LIGHT® device. Best-corrected visual acuity (BCVA), low luminance visual acuity (LLVA), mean drusen volume (MDV), and CC flow deficit percentage (FD%) were evaluated at baseline and 2-month follow-up. Results: The PBM group showed significant improvements in BCVA (Δ +3.2 ± 1.4 letters, p = 0.042), reduction in drusen volume (Δ –0.003 ± 0.001 mm³, p = 0.028), and decrease in choriocapillaris FD% (Δ –3.1 ± 1.4%, p = 0.024), while no significant changes were observed in the control group. Changes in choriocapillaris FD% correlated with BCVA improvement (r = –0.54, p = 0.002) and drusen volume reduction (r = 0.35, p = 0.042). Conclusions: PBM therapy induces significant choriocapillaris remodelling in intermediate AMD, associated with functional improvement and drusen volume reduction. These findings suggest a potential therapeutic role of PBM in modulating choroidal perfusion in AMD.