About 2RT

2RT® Retinal Rejuvenation is a breakthrough light therapy that uses a gentle, extremely short duration laser. This stimulates the eye's natural healing response to treat intermediate AMD1,4 and CSME.

2RT® enables treatment 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 cases of CSME, 2RT® addresses the swelling of the retina without eliciting collateral damage to sensitive eye structures that are vital for vision.

How does 2RT® work?

2RT® applies nanosecond pulses of low-energy laser light to selected individual cells within the retinal pigment epithelium (RPE), a layer of cells within the retina that is responsible for maintaining and nourishing the retina and removing waste products. Clinical studies have shown that the application of the 2RT® laser light can slow the progression from intermediate AMD to late-stage AMD1,4, potentially eliminating the vision loss associated with AMD. 2RT® has also been demonstrated to resolve the swelling associated with cases of CSME.

What happens 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 in 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.

What can I expect after treatment?

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 and CSME is a lifelong process; even with 2RT® you will need to continue to visit your ophthalmologist every three to six months. It is also likely that you will need to undergo treatment with 2RT® every 6 months.

Complications and 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.1,2,3 In a recent clinical trial, haemorrhage occurred in 11 patients (6.8% of the patient population), but resolved without further sequelae.4

Who will benefit from 2RT®?

It is necessary to first undergo an eye examination in order to determine your suitability for 2RT®. Upon discussion with your ophthalmologist, a number of factors will determine whether 2RT® is a suitable treatment option.

What is a Nanosecond Pulse?

A nanosecond is one billionth (10-9 or .000000001) of a second. The nanosecond pulse of 2RT® enables it to achieve the desired therapeutic effect without causing unnecessary damage to the sensitive structures of the eye. 

2RT® in the LEAD clinical trial

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 study, 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 3 years.

Despite not reaching statistical significance, when considering all patients enrolled in the trial, there was a trend to delay progression from early to late stage AMD in those treated with 2RT® Retinal Rejuvenation Therapy.

Post hoc analyses showed that in patients who did not have coexistent reticular pseudodrusen (RPD), a fatty deposit that is associated with later stages of AMD (76% of patients enrolled), treatment with 2RT® resulted in a clinically meaningful 77% reduction in the rate of disease progression.

“While this isn’t a cure, and it is not suitable for every patient with AMD in its early stages, the impressive outcomes in reducing progression to late AMD are important as this is the first time that a laser intervention has shown promise in addressing AMD disease progression in more than 20 years of AMD laser research.”

Prof. Robyn Guymer AM, MBBS, PhD, FRANZCO, FAAHMS

Professor Robyn Guymer AM, MBBS, PhD, FRANZCO, FAAHMS, the Principal Investigator for the Laser for Early AMD (LEAD) clinical trial, explains the importance of monitoring early signs of AMD and how 2RT®shows promise in the clinical trial results to address age-related macular degeneration. Professor Guymer highlights the advancement to today’s laser technology with respect to 2RT® being uniquely protective compared to other retinal laser treatments.

2RT® in the LEAD clinical trial

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.

1. Guymer RH, et al. Nanosecond-laser application in intermediate AMD – 12-month results of fundus appearance and macular function. Clin Exp Ophthalmol. 2014;42(5):466-79. doi: 10.1111/ceo.12247. Epub 2013 Nov 11.

2. Pelosini LP, et al. Retina rejuvenation therapy for diabetic macular edema: a pilot study. Retina. 2013 Mar;33(3):548-58. doi: 10.1097/IAE.0b013e3182670fea.

3. Casson RJ, et al. Pilot randomized trial of a nanopulse retinal laser versus conventional photocoagulation for the treatment of diabetic macular oedema. Clin Exp Ophthalmol. 2012;40(6):604-10. doi: 10.1111/j.1442-9071.2012.02756.x. Epub 2012 Mar 21.

4. Guymer RH, et al. Sub-Threshold Nanosecond Laser Intervention in Age-Related Macular Degeneration: The LEAD Randomized Controlled Clinical Trial. Ophthalmology. 2018 Sep 19. doi: 10.1016/j.ophtha.2018.09.015. [Epub ahead of print]

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