For decades, telling a patient they had dry macular degeneration meant delivering some of the most difficult news in eye care. I would sit across from patients worried about losing their ability to read, drive, or enjoy time with family, and explain that we had very few treatment options.

The advice was always the same: take appropriate vitamins, don't smoke, maintain a healthy lifestyle, monitor your vision, and come in for regular exams. Beyond that, our approach was largely one of careful observation. We were managing the disease as best we could, but we had little to offer in terms of active treatment.

Today, that paradigm is changing.

A new option for dry AMD

Dry age-related macular degeneration (AMD) is the most common form of macular degeneration, affecting millions of Americans. Unlike wet AMD, for which effective injectable treatments have been available for nearly two decades, patients with earlier stages of dry AMD historically had no treatment specifically designed to address the disease itself. While the AREDS2 vitamin formulation can reduce the risk of progression in certain patients, active treatment options remained severely limited.

However, in November 2024, the FDA authorized the Valeda® Light Delivery System for the treatment of dry AMD. Valeda utilizes a technology called photobiomodulation (PBM), offering a noninvasive approach for appropriately selected patients with intermediate dry AMD before the development of advanced geographic atrophy.

What is photobiomodulation?

While light-based therapies have been used for years in other medical fields for wound healing and inflammation, its application in ophthalmology is a major milestone.

PBM uses carefully controlled wavelengths of red and near-infrared light delivered to the retina during a series of brief, painless office treatments. The light is absorbed by mitochondria—the energy-producing structures within cells. Researchers believe this process supports cellular metabolism while reducing the oxidative stress and inflammation that drive the progression of macular degeneration.

The standard treatment protocol consists of nine short sessions performed over approximately three to five weeks. Based on clinical trials, additional treatment series may be recommended periodically.

What does the research show?

The LIGHTSITE III clinical trial evaluated photobiomodulation in patients with intermediate dry AMD over two years. The results were highly encouraging:

•  Improved vision: Patients receiving PBM experienced an average improvement in visual acuity compared to those who received a sham treatment.

•  Measurable gains: More than 60% of treated eyes gained at least five letters on the standard ETDRS visual acuity chart.

•  Slower progression: The study suggested that treated patients may experience lower rates of progression to advanced geographic atrophy.

•  Safety: The treatment was well tolerated with no significant safety concerns identified.

A note of caution: Photobiomodulation is not a cure, and it does not guarantee improved vision for every patient. As an ophthalmologist, I believe in balancing optimism with reality. Patients deserve accurate information and realistic expectations, not exaggerated promises.

Who is a candidate?

Patient selection is critical. Current evidence and FDA authorization focus specifically on patients with intermediate dry AMD. Determining whether this treatment is appropriate requires a comprehensive eye examination, detailed retinal imaging, and an individualized evaluation by an ophthalmologist or retina specialist.

What this means for you

If you were told years ago that there was "nothing to do" for your dry AMD, it is time to have another conversation with your eye doctor. PBM does not replace the fundamentals of care—patients must still take vitamins, avoid smoking, and undergo regular monitoring—but it offers a powerful new tool in our arsenal.

At Milford Franklin Eye Center, we are proud to be the fourth center in Massachusetts—and the only one in our local area—to offer photobiomodulation therapy with the Valeda system through our Franklin office.

We are also proud to provide comprehensive, on-site retina specialty care through Dr. Alyse Richard, a highly trained retina specialist dedicated to advanced, patient-centered care for complex retinal conditions.

After many years of simply monitoring dry AMD, I am grateful we finally have more to offer. If you or a loved one has been diagnosed with dry AMD, contact Milford Franklin Eye Center today to schedule a comprehensive retinal evaluation.

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