AAOpt 2026: Photobiomodulation to revolutionize dry AMD treatment, Dr Rafieetary says

Mohammad Rafieetary, OD, FAAO, FORS, DipABO, ABCMO, discussed photobiomodulation (PBM) as a newer treatment option for dry age-related macular degeneration (AMD), a condition he said has traditionally been managed by monitoring patients, recommending lifestyle measures and vitamins, and treating complications such as wet AMD or geographic atrophy when they arise with Optometry Times. In part of his AAOpt 2026 presentation “Photobiomodulation in Age-Related Macular Degeneration: Evidence, Mechanisms, and Clinical Integration,” he described PBM as a way to potentially slow progression—and in some cases improve the disease—rather than waiting for further deterioration.

Rafieetary explained that the treatment uses specific light wavelengths to stimulate cytochrome c oxidase, an enzyme in the mitochondria involved in cellular energy production. The FDA-cleared instrument he discussed uses wavelengths of 590, 660, and 850 nanometers. He said the intended effects include supporting mitochondrial function, reducing VEGF production and inflammation, and increasing nitric oxide. Rafieetary compared the selective use of light wavelengths to photosynthesis, while noting that the device filters out harmful rays.

The treatment course consists of 9 sessions over roughly 3-5 weeks. Each eye takes about 5 minutes, and both can be treated at the same time. Patients do not need dilation or routine vision and pressure checks during each session; they return for treatments daily or every other day, depending on the schedule. About a month and a half after the course, Rafieetary typically reassesses patients with OCT imaging. He said he is often looking for stabilization and has seen encouraging results.

Rafieetary said current FDA clearance and insurance criteria apply to early-to-intermediate AMD and specify a visual-acuity range. He raised concerns that these criteria may exclude people with good measured vision but substantial disease, and that visual-acuity requirements can be difficult to interpret when clinics use different charts. Rafieetary also described uneven Medicare coverage: he said patients in Mississippi and Arkansas could receive coverage, while patients in Tennessee could not.

Looking ahead, Rafieetary expects PBM or a related form of the technology to remain in use over the next 5 years, but emphasized that broader applications—including diabetic macular edema—require further study and regulatory clearance. He identified advocacy, expanded insurance coverage, and possible changes to FDA labeling as important ways to improve access. He also noted growing patient interest, while cautioning that a patient with very advanced disease may be beyond the treatment’s intended use.