Episode Details

Christopher Wolfe, OD, FAAO, examines how clinicians should evaluate photobiomodulation for dry age-related macular degeneration (AMD). The key question: should treatment be judged only by visual acuity gains, or also by whether it may affect disease progression in patients whose vision is still good?He reviews evidence related to drusen volume, geographic atrophy (GA), conversion to wet AMD, and other measures of visual function. He also considers treatment frequency, patient burden, and what further research is needed before clinicians can confidently reduce the current treatment schedule.
Key topics
Why visual acuity improvement may not be the only meaningful measure of benefit in dry AMD
How photobiomodulation compares with the preventive goals of AREDS 1 and AREDS 2
Findings on drusen volume from the Iovino and LightSite studies
What the available evidence does—and doesn’t—show about conversion to wet AMD and development of GA
Functional outcomes beyond standard high-contrast visual acuity, including contrast sensitivity and low-luminance visual acuity
What may happen when treatment stops, and why ongoing management may be needed
The current treatment schedule discussed in the episode: nine treatments over three weeks, repeated every four months
Why evidence is still needed to determine whether fewer treatments or longer intervals can maintain benefit
How clinicians can discuss potential benefits, uncertainty, treatment burden, and patient preferences
Timestamps
00:13 — The central question: is visual acuity the only measure of benefit?
01:39 — The question for category 3 patients with good visual acuity
03:02 — The comparison with AREDS 1 and AREDS 2
05:00 — Evidence on drusen volume
06:25 — What the studies suggest about conversion to wet AMD
07:50 — Geographic atrophy findings
09:19 — Looking at photobiomodulation through a disease-progression lens
10:16 — Functional measures beyond the eye chart
11:14 — What happens to measured benefits after treatment stops
12:10 — Retreatment intervals and sustaining benefit
14:07 — The treatment burden of the current protocol
15:02 — The limits of anecdotal evidence when considering fewer treatments
15:57 — Wearable and at-home approaches: promising, but not yet a replacement
16:50 — The current best-supported schedule discussed in the episode
17:20 — The research question that could change clinical practice
18:17 — Explaining the evidence and options to patients
20:10 — Why visual acuity should not be the only definition of success

AMD Implementation Workshop — October 29, 2026

Want to take these concepts beyond the podcast and actually build an AMD system for your practice?

Join Dr. Chris Wolfe for the AMD Implementation Workshop in Grapevine, Texas, on October 29, 2026.

This all-day workshop will take a deeper dive into creating an AMD management protocol for your individual practice—from identifying the right patients and establishing KPIs to integrating testing, supplementation conversations, patient education, treatment options, and staff workflows.

Learn more and register:
https://www.practiceperformancepartners.com/amd-implementation-workshop/?utm_source=hs_email&utm_medium=email

FREE Complete Clinical AMD Management Course for Podcast Listeners

Want to dive deeper into the clinical side before the workshop?

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Access the course:
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Podcast Listener Coupon Code: ece2026amdpromo

Offer expires October 31, 2026.