Are you worried about vision loss associated with AGE-RELATED MACULAR DEGENERATION (AMD) or DIABETES?
2RT Retinal Rejuvenation is a gentle, restorative treatment that can be applied earlier in the disease to preserve and renew important vision structures in your eye.
2RT Retinal Rejuvenation is a gentle, restorative treatment that can be applied earlier in the disease to preserve and renew important vision structures in your eye.
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2RT can delay the rate of age-related macular degeneration (AMD) progression. It can also potentially eliminate, or at the very least delay the need for medical injections into your eye.
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2RT is suitable for diabetic patients with Clinically Significant Macular Edema (CSME). In some cases, 2RT may also be an effective adjunct therapy to anti-VEGF medications for select patients.
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To find out more about 2RT laser, click the button below to make an appointment:
What is 2RT?
2RT, also known as Retinal Rejuvenation Therapy, is a breakthrough light therapy that uses a non-invasive, gentle, extremely short duration retinal laser that stimulates a natural, biological healing response in the eye to stop or slow the degenerative processes that cause Age-Related Macular Degeneration (AMD).
The gentle light treatment preserves the eye’s sensitive structures, as 2RT uses 500 times less energy than conventional retinal laser therapy. 2RT can effectively treat CSME (macular swelling causing vision loss) in diabetic patients without heat damage to the retina and surrounding cells.
It is performed in your ophthalmologist’s clinic and typically takes no more than 10 minutes.
Conventional retinal laser therapy uses millisecond treatment times. In contrast, 2RT applies nanosecond pulses (pulses lasting three billionths of a second or 0.000000003 seconds) of low-energy laser light to induce the desired therapeutic effect whilst avoiding heat damage to the sensitive structures of the eye.
In AMD, repeated ongoing eye injections (anti-vascular endothelial growth factor medications, anti-VEGF) are suitable for the wet, end-stage of the disease only. In contrast, 2RT is applied much earlier in the disease process - slowing the rate of disease progression and preserving functional vision before irreversible physical damage and vision loss occurs.
In diabetes, 2RT can be used to reduce the swelling of the retina associated with CSME, stopping or slowing the progression of the disease
Read our news blog about 2RT:
The gentle light treatment preserves the eye’s sensitive structures, as 2RT uses 500 times less energy than conventional retinal laser therapy. 2RT can effectively treat CSME (macular swelling causing vision loss) in diabetic patients without heat damage to the retina and surrounding cells.
It is performed in your ophthalmologist’s clinic and typically takes no more than 10 minutes.
Conventional retinal laser therapy uses millisecond treatment times. In contrast, 2RT applies nanosecond pulses (pulses lasting three billionths of a second or 0.000000003 seconds) of low-energy laser light to induce the desired therapeutic effect whilst avoiding heat damage to the sensitive structures of the eye.
In AMD, repeated ongoing eye injections (anti-vascular endothelial growth factor medications, anti-VEGF) are suitable for the wet, end-stage of the disease only. In contrast, 2RT is applied much earlier in the disease process - slowing the rate of disease progression and preserving functional vision before irreversible physical damage and vision loss occurs.
In diabetes, 2RT can be used to reduce the swelling of the retina associated with CSME, stopping or slowing the progression of the disease
Read our news blog about 2RT:
Is 2RT proven?
The Laser Intervention in Early AMD (LEAD) clinical trial, a large randomized, controlled clinical trial, has demonstrated the potential for 2RT to significantly reduce the rate of disease progression in a specific group of intermediate AMD patients. The trial, which enrolled 292 patients, examined whether the application of 2RT could delay progression of intermediate AMD to late-stage disease. Each participant was randomly assigned to 2RT treatment, or a sham laser procedure (placebo group) and received treatment and/or follow-up over three years.
When considering the results in all of the patients treated with 2RT Retinal Rejuvenation Therapy, it was found that there was a slight reduction in progression from early to late stage AMD compared to those who did not receive the treatment.
However, when patients who had intermediate AMD with more severe features (those with coexistent reticular pseudodrusen or RPD - a fatty deposit that is associated with more advanced disease of the macula) were removed from the study, the remaining 76% of patients enrolled in the study, showed a clinically meaningful 77% (or nearly four-fold) reduction in the rate of disease progression to late AMD as a result of 2RT treatment.
As eye injections are required in wet AMD, one form of late AMD, it can be said that 2RT reduces the risk or prevents the need for these injections in patients with intermediate AMD without RPD.
The LEAD study report, which was published in September 2018, is reproduced below:
When considering the results in all of the patients treated with 2RT Retinal Rejuvenation Therapy, it was found that there was a slight reduction in progression from early to late stage AMD compared to those who did not receive the treatment.
However, when patients who had intermediate AMD with more severe features (those with coexistent reticular pseudodrusen or RPD - a fatty deposit that is associated with more advanced disease of the macula) were removed from the study, the remaining 76% of patients enrolled in the study, showed a clinically meaningful 77% (or nearly four-fold) reduction in the rate of disease progression to late AMD as a result of 2RT treatment.
As eye injections are required in wet AMD, one form of late AMD, it can be said that 2RT reduces the risk or prevents the need for these injections in patients with intermediate AMD without RPD.
The LEAD study report, which was published in September 2018, is reproduced below:
Professor Erica Fletcher, PhD, Leader of the Fundamental Research Program in the Laser for Early AMD (LEAD) clinical trial, explains how 2RT may remove the early signs of age-related macular degeneration. Professor Fletcher highlights the protective characteristics of 2RT compared to other ophthalmic laser treatments being used to address eye disease.
With regard to diabetes and CSME, a smaller randomized clinical trial has demonstrated the improved safety profile and efficacy of 2RT in patients with CSME compared to traditional retinal photocoagulation - an earlier type of laser treatment.
While retinal photocoagulation laser is effective at treating CSME, maintaining vision and reducing macular swelling, the treatment results in collateral damage to the parts of the retina crucial to vision.
2RT is capable of achieving the same degree of clinical efficacy as conventional retinal photocoagulation laser, but without damage to the overlying neurosensory retina (specifically, no damage is caused to the photoreceptors or light receiving cells of the retina). 2RT achieves this effect by rejuvenating the aged, compromised retinal pigment epithelium (RPE) – a layer of support cells in the retina.
While retinal photocoagulation laser is effective at treating CSME, maintaining vision and reducing macular swelling, the treatment results in collateral damage to the parts of the retina crucial to vision.
2RT is capable of achieving the same degree of clinical efficacy as conventional retinal photocoagulation laser, but without damage to the overlying neurosensory retina (specifically, no damage is caused to the photoreceptors or light receiving cells of the retina). 2RT achieves this effect by rejuvenating the aged, compromised retinal pigment epithelium (RPE) – a layer of support cells in the retina.
Who will benefit from 2RT?
It is necessary to first undergo an eye examination to determine your suitability for 2RT. Upon discussion with your ophthalmologist, a number of factors will determine whether 2RT is a suitable treatment option.
Simply speaking, you have to have intermediate AMD to have any benefit from this treatment. Up to 76% of patients with dry AMD, that is the majority, may be suitable.
Intermediate AMD refers to a stage of AMD in which your eyes show the following signs:
Simply speaking, you have to have intermediate AMD to have any benefit from this treatment. Up to 76% of patients with dry AMD, that is the majority, may be suitable.
Intermediate AMD refers to a stage of AMD in which your eyes show the following signs:
- medium drusen and pigment changes, or
- large drusen
Your optometrist will refer you if your AMD is in this category.
In addition, if you have CSME (diabetic macular swelling), 2RT offers a safer and non-damaging alternative to conventional thermal lasers.
How does 2RT work?
2RT applies nanosecond pulses of low-energy laser light to selected individual cells within the retinal pigment epithelium (RPE). Clinical studies have shown that the application of the 2RT laser light can slow the progression from intermediate AMD to late stage AMD, potentially eliminating the vision loss associated with AMD.
2RT uses 500 times less energy than conventional retinal laser treatment, and eliminates the incidence of thermal damage – thereby representing a major breakthrough in the laser-based treatment of CSME in diabetics.
2RT uses 500 times less energy than conventional retinal laser treatment, and eliminates the incidence of thermal damage – thereby representing a major breakthrough in the laser-based treatment of CSME in diabetics.
The patented 2RT technology features a speckled beam profile which exclusively targets selected, individual cells within the retinal pigment epithelium (RPE), a layer of support cells beneath the retina. The application of 2RT to the RPE results in the formation of microbubbles around the melanosomes. These microbubbles expand and then coalesce, causing intracellular damage. A process of extracellular signaling occurs in response to the selected death of the targeted RPE cells, which causes the neighboring RPE cells to migrate and proliferate into the cell space vacated by these dead RPE cells. This stimulates a process of cell division and growth. This means that as the 2RT causes selected cells of the RPE to die, sister cells around the targeted are stimulated to produce daughter cells, which improves permeability or leakiness of Bruch’s membrane and thereby restores the transport of fluid across Bruch’s membrane. restoring the function of the macula. As a result, the RPE is rejuvenated – and without damage to the overlying neurosensory retina.
Drusen in a patient with AMD before (a) and after (b) 2RT 3 ns pulse laser therapy
Drusen are white-yellow deposits under the macula and are the tell tale sign of macular degeneration/ AMD. The number and size of drusen are directly related to the severity of AMD - the larger the drusen are, the more there are and the larger the area they cover in the macula, the more severe is the AMD and the greater the risk of progression to wet AMD.
2RT has been shown to decrease the number, size and area of drusen coverage, which suggests that the laser treatment is able to reverse the early ageing changes of AMD.
2RT has been shown to decrease the number, size and area of drusen coverage, which suggests that the laser treatment is able to reverse the early ageing changes of AMD.
2RT: what to expect
Step 1 Initial consultation
The first step is to determine if you are a good candidate for the procedure. Our experienced clinical team will conduct a thorough examination of your eye to determine your eligibility for treatment with 2RT.
On the day of your exam, we will check the stability of your vision and the overall health of your eyes to make sure that you are a suitable candidate for 2RT. These tests will include photographs and scans of your macula and retina.
Step 2 During the procedure
2RT Retinal Rejuvenation is performed as a ‘walk-in, walk-out’ procedure in the ophthalmologist’s rooms; you do not have to stay overnight in a hospital.
Immediately prior to treatment, your ophthalmologist will administer eye drops to prepare the eye for treatment. A contact lens will then be placed on your eye and spots of the 2RT laser light delivered through a specially designed microscope, similar to that used for eye examinations. During the procedure you will hear a clicking sound. You may also see a flashing light; this is the aiming beam used by the ophthalmologist to position the laser light in your eye.
Typically, 2RT does not cause any pain. You may experience slight pressure on your eye upon application of the contact lens, but it is important to note that you will not feel the application of the laser light.
Step 3 After the procedure
Once the treatment is complete, you may leave the clinic when you are comfortable. You will need a person to drive you home. It is very important to follow your post-operative instructions and attend follow-up visits.
You can resume normal, day-to-day activities, such as watching TV, soon after treatment. Your ophthalmologist will want to re-check the treated eye during periodic follow-up visits. It is important to remember that managing AMD is a lifelong process; even with 2RT you will need to continue to visit your ophthalmologist every 3 – 6 months. It is also likely that you will need to undergo treatment with 2RT every 6 months.
The first step is to determine if you are a good candidate for the procedure. Our experienced clinical team will conduct a thorough examination of your eye to determine your eligibility for treatment with 2RT.
On the day of your exam, we will check the stability of your vision and the overall health of your eyes to make sure that you are a suitable candidate for 2RT. These tests will include photographs and scans of your macula and retina.
Step 2 During the procedure
2RT Retinal Rejuvenation is performed as a ‘walk-in, walk-out’ procedure in the ophthalmologist’s rooms; you do not have to stay overnight in a hospital.
Immediately prior to treatment, your ophthalmologist will administer eye drops to prepare the eye for treatment. A contact lens will then be placed on your eye and spots of the 2RT laser light delivered through a specially designed microscope, similar to that used for eye examinations. During the procedure you will hear a clicking sound. You may also see a flashing light; this is the aiming beam used by the ophthalmologist to position the laser light in your eye.
Typically, 2RT does not cause any pain. You may experience slight pressure on your eye upon application of the contact lens, but it is important to note that you will not feel the application of the laser light.
Step 3 After the procedure
Once the treatment is complete, you may leave the clinic when you are comfortable. You will need a person to drive you home. It is very important to follow your post-operative instructions and attend follow-up visits.
You can resume normal, day-to-day activities, such as watching TV, soon after treatment. Your ophthalmologist will want to re-check the treated eye during periodic follow-up visits. It is important to remember that managing AMD is a lifelong process; even with 2RT you will need to continue to visit your ophthalmologist every 3 – 6 months. It is also likely that you will need to undergo treatment with 2RT every 6 months.
This participant shares her personal experience with 2RT and her involvement in the Laser for Early Age-related Macular Degeneration (LEAD) clinical trial:
FAQs
Is 2RT safe?
2RT has been clinically proven to be a safe treatment. Numerous studies have shown the safety profile of the therapy including a multi-center, clinical trial that has demonstrated a high safety-benefit profile for 2RT in suitable patients.
Will the procedure hurt?
The 2RT procedure is painless. There may be some discomfort from the laser lens placed against your eye. You may see the green flash of the laser light, but you will not feel the application of the laser light.
How long does it take?
The 2RT procedure takes approximately 10 minutes.
What are the side effects?
As with any eye procedure, there may be side effects associated with 2RT. Before undergoing 2RT, it is recommended to first discuss the possible risks and benefits of the procedure with your ophthalmologist. Clinical studies have demonstrated that complications or adverse events associated with 2RT, both during and after the procedure, are very rare. According to the results of a recent multi-center trial, there were rare reports of mild retinal bleeding and after-images but these did not cause further problems for the patient and did not require additional treatment
How do I know 2RT has worked?
You will require follow-up visits with your ophthalmologist, who will perform repeat photography and scans to monitor the success of 2RT treatment, which aims to prevent progression of AMD and CSME and stabilize your eye’s health.
How often do I need to have 2RT?
It is important to remember that managing AMD and diabetic CSME is a lifelong process; even with 2RT you will need to continue to visit your ophthalmologist every 3 – 6 months. While every case is different, typically, you may need to undergo treatment with 2RT every 6 months.
How long is the recovery?
Your eye care professional may treat your eye with lubricant eye drops following treatment, if required, but this will not affect your vision. Immediately following treatment, you will be able to complete everyday activities, including driving your car.
Can 2RT treat all types of age-related macular degeneration and diabetic CSME?
2RT is a potential treatment for suitable patients with intermediate AMD and some CSME, as determined by your ophthalmologist. Other forms of macular degeneration can occur in much younger people although these are generally due to a genetic condition.
Is 2RT available in Warrnambool?
2RT is now available in Dr Vincent Lee's practice at South West Eye Surgery on Koroit Street. Ring for an appointment or click the CONTACT button below to provide your details and we will get back to you to arrange an appointment.
2RT has been clinically proven to be a safe treatment. Numerous studies have shown the safety profile of the therapy including a multi-center, clinical trial that has demonstrated a high safety-benefit profile for 2RT in suitable patients.
Will the procedure hurt?
The 2RT procedure is painless. There may be some discomfort from the laser lens placed against your eye. You may see the green flash of the laser light, but you will not feel the application of the laser light.
How long does it take?
The 2RT procedure takes approximately 10 minutes.
What are the side effects?
As with any eye procedure, there may be side effects associated with 2RT. Before undergoing 2RT, it is recommended to first discuss the possible risks and benefits of the procedure with your ophthalmologist. Clinical studies have demonstrated that complications or adverse events associated with 2RT, both during and after the procedure, are very rare. According to the results of a recent multi-center trial, there were rare reports of mild retinal bleeding and after-images but these did not cause further problems for the patient and did not require additional treatment
How do I know 2RT has worked?
You will require follow-up visits with your ophthalmologist, who will perform repeat photography and scans to monitor the success of 2RT treatment, which aims to prevent progression of AMD and CSME and stabilize your eye’s health.
How often do I need to have 2RT?
It is important to remember that managing AMD and diabetic CSME is a lifelong process; even with 2RT you will need to continue to visit your ophthalmologist every 3 – 6 months. While every case is different, typically, you may need to undergo treatment with 2RT every 6 months.
How long is the recovery?
Your eye care professional may treat your eye with lubricant eye drops following treatment, if required, but this will not affect your vision. Immediately following treatment, you will be able to complete everyday activities, including driving your car.
Can 2RT treat all types of age-related macular degeneration and diabetic CSME?
2RT is a potential treatment for suitable patients with intermediate AMD and some CSME, as determined by your ophthalmologist. Other forms of macular degeneration can occur in much younger people although these are generally due to a genetic condition.
Is 2RT available in Warrnambool?
2RT is now available in Dr Vincent Lee's practice at South West Eye Surgery on Koroit Street. Ring for an appointment or click the CONTACT button below to provide your details and we will get back to you to arrange an appointment.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner