## 3 Current Applications
### Retina
#### 3.2.1 Age-Related Macular Degeneration
In the TORPA 1 trial, 18 eyes classified as AREDS stages 2 to 4 of patients aged 50 or older with a visual acuity between 0.1 and 1.0 were included. Devices used were Warp10 (Quantum Devices) (670 nm \(\pm\) 15 nm at 50-80 mW/cm\({}^{2}\), 4-7.68 J/cm\({}^{2}\), for 88 \(\pm\) 8 s) and Gentlewaves (Light Bioscience) (590 nm \(\pm\) 8 nm at 4 mW, 790 nm \(\pm\) 60 nm at 0.6 mW, for 30 s). Individuals received a direct transpupillary treatment 18 times within a span of 6 weeks using both devices. They reported an improvement in both visual acuity and contrast sensitivity at 12 months ([PERSON] _et al._, 2018). In the TORPA 2 trial, 42 eyes were treated with the same devices of TORPA 1 trial according to protocol consisting of 3 treatments per week for 3 weeks. A significant improvement in visual acuity, contrast sensitivity, and anatomical parameters such as drusen volume was reported ([PERSON] _et al._, 2018). These results are consistent with those reported in LIGHTISITE I, II, and III trials. LIGHTISITE I is a randomized, sham-controlled, single-center study investigating the impact of PBM on AMD. The Valeda Light Delivery System (LumiThera, Inc., Poulsbo, WA, USA) (590 nm, 5 mW/cm\({}^{2}\), 70 s, 670 nm, 65 mW/cm\({}^{2}\), 70 s, 850 nm, 8 mW/cm\({}^{2}\), 180 s) was used in patients with dry AMD who received 9 treatments (3 treatments per week for 3 weeks) at baseline and after 6 months. The efficacy of PBM appeared to require periodic retreatments, typically ranging from 4 to 6 months, indicating that although significant improvements in visual acuity and contrast sensitivity are initially achieved, these effects are not sustained over the long term without follow-up treatments ([PERSON] _et al._, 2018). The LIGHISITE II study was a double-masked, randomized, sham-controlled, parallel group, multicenter prospective study that investigates the safety and efficacy of PBM treatment in 44 eyes of patients with intermediate non-exudative AMD. Thirty-five percent of the eyes which completed all PBM sessions with the Valeda System showed an improvement in visual acuity. Furthermore, the study found that an increase over time of macular drusen volume was registered in the sham group but not in the PBM-treated group. Although both PBM and sham groups exhibited a growth in geographic atrophy lesions during the study period, the PBM group demonstrated a reduced growth rate over the course of 10 months. However, the study comes with several limitations. Firstly, the variation in disease severity between the treatment and control groups at the beginning makes it more challenging to interpret the results accurately. Additionally, a notable limitation is the small number of participants who actually completed the planned treatment in the LIGHISITE II study, with only 27 subjects receiving it (LIGHTISITE II); _et al._ (2018). LIGHTISITE III is a prospective, randomized controlled trial compelling evidence of enhanced clinical and anatomical outcomes in individuals with intermediate dry AMD following PBM performed with the Valeda System. A total of 148 eyes of 200 patients were included, most of them belonging to AREDS 3 stage. Notably, in the preliminary results reported at 13 months, the PBM group demonstrated a significant improvement in visual acuity and a reduction in the occurrence of new-onset geographic atrophy. However, regarding BCVA, it is worth asking whether a mere 2-letter improvement holds clinical significance. However, the transition rate from non-exudative to exudative AMD was higher in the group receiving PBM compared to the control group ([PERSON] _et al._, 2018). In a pilot study by [PERSON] and colleagues, the authors aimed at evaluating the effect of 670 nm light on dark adaptometry, considered as a biomarker for AMD. Surprisingly, the light exposure did not impact the AMD group but reduced rod-recovery time in healthy aging eyes. Structural volumetric analysis revealed no significant alterations in drusen volume or beneficial effects on the outer nuclear layer after 12 months.