Am I a Candidate for Valeda Light Therapy?
Am I a Candidate for Valeda Light Therapy?
Valeda is not right for everyone with macular degeneration, and we would rather tell you that clearly here than have you make a trip to find out.
The FDA authorized Valeda for a specific group of people: those with early to intermediate dry AMD whose vision still falls within a particular range. If you fall outside that range, in either direction, Valeda is unlikely to be the right option, and there may well be something else that is.
Below is exactly what we look for, what rules it out, and what happens at the visit where we decide.
Who Is a Good Candidate?
PBM with Valeda is intended for people with:
- Early to intermediate dry AMD (not wet AMD)
- Best-corrected vision roughly between 20/32 and 20/70
- Medium or large drusen and/or non-central geographic atrophy in the macula, without center-involving disease or neovascular (wet) AMD
- Symptoms affecting daily life, such as difficulty reading, driving, recognizing faces, or seeing in dim light
It is not designed for eyes where advanced geographic atrophy already involves the center of vision.
You Are Likely Not a Candidate If
- You have wet AMD in that eye, or are receiving injections for it
- Your best-corrected vision is better than 20/32, meaning the disease has not yet affected your vision enough
- Your best-corrected vision is worse than 20/70
- Geographic atrophy already involves the center of your macula
- You have known photosensitivity to yellow, red, or near-infrared light
- You have a history of light-activated epilepsy or light-activated migraine
Being on this list does not mean nothing can be done. It means Valeda specifically is not the right tool, and the conversation turns to what is. More on that below.
The Stage of Your Dry AMD
Valeda is intended for dry age-related macular degeneration, not the wet form. If you are receiving injections for wet AMD in an eye, Valeda is not indicated for that eye.
Within dry AMD, the treatment is meant for the earlier and middle stages. In practical terms, that generally means one of two findings on your exam and imaging:
- Drusen, the small yellowish deposits that accumulate beneath the retina, present in a certain number and size
- Geographic atrophy that has not yet reached the center of your macula
That second point matters more than it may sound. Geographic atrophy is an advanced form of dry AMD in which areas of retinal tissue thin and stop working. If those areas sit off to the side of your central vision, Valeda may still be appropriate. If the atrophy has moved into the center, it is not.
This is not something you can determine at home, and it is not something a vision screening at the pharmacy or the DMV will tell you. It requires retinal imaging.
Your Best-Corrected Vision
The FDA authorization for Valeda specifies best-corrected visual acuity between 20/32 and 20/70.
Best-corrected means measured with your current glasses or contact lenses on. It is not how well you see across the kitchen without them.
Two things follow from that range, and both tend to surprise people.
If your vision is better than 20/32, you are not currently a candidate. This can be a difficult thing to hear, because it means being told your vision is in a sense too good, which is not what someone worried about a new diagnosis expects. Valeda was studied in people whose vision had already begun to be affected. If you are earlier than that, we will talk with you about monitoring intervals, AREDS2 supplementation where appropriate, and which changes should bring you back in sooner.
If your vision is worse than 20/70, Valeda is not indicated either. That does not mean nothing can be done. It usually means the conversation shifts toward clinical trials, low vision resources, and confirming that nothing treatable has been overlooked.
What Rules Valeda Out
A small number of things make Valeda inappropriate regardless of the state of your retina:
- Known photosensitivity to yellow light, red light, or near-infrared light
- A history of light-activated central nervous system disorders, including light-triggered epilepsy and light-triggered migraine. Please tell us if you have either, even if it has been years since your last episode. This rules out more people than you might expect, and it is easy to forget to mention.
- Certain medications that increase sensitivity to light. Bring your complete medication list, including supplements and anything prescribed by another physician. Some medications require a waiting period after the last dose before treatment can begin.
If you are unsure whether something on your list applies, bring it anyway and let us sort it out. There is no such thing as an unnecessary detail here.
What the Evaluation Visit Involves
Determining candidacy takes one visit.
We will measure your best-corrected vision, dilate your eyes, and take retinal images, typically OCT, which shows the layers of your retina in cross section, along with photographs of the back of the eye. Together these tell us the size and distribution of any drusen, whether atrophy is present, where it sits relative to your central vision, and whether there is any sign of the wet form.
Plan for your eyes to be dilated at this visit, which means blurred near vision and light sensitivity for several hours afterward. Please arrange for someone to drive you home. Note that this applies to the evaluation only. Valeda treatment sessions themselves require no dilation, no eye drops, and no needles.
At the end of that visit, your physician will tell you plainly whether Valeda is an option for you, and if it is not, what is.
What Treatment Asks of You
We want you to understand this before you decide rather than partway through.
Valeda is not a one-time treatment. Sessions are delivered in a series of 9 treatments per eye over a three to five week period, and the series is repeated every four months on an ongoing basis. Within a 12 month span, that comes to 27 treatments. The full regimen studied and authorized runs to 54 treatments across two years.
Each individual visit is brief, about 15 minutes, with the treatment itself taking less than 5 minutes per eye. There is no downtime and you can resume normal activity immediately. The regimen as a whole, however, is a real commitment of time and travel repeated over two years. It is worth thinking through honestly, including where you live, who drives you, and what your next two years look like, before you begin.
It is also worth understanding that benefit is not guaranteed, and that any benefit may not persist once treatment stops. Your physician will walk you through what the clinical trial data does and does not show, and what it may mean for someone in your particular situation.
If Valeda Is Not the Right Fit
Not being a candidate is not the end of the conversation, and we do not treat it that way.
Depending on what we find, the discussion may turn toward clinical trials. Retina Consultants San Diego maintains an active research program, and dry AMD is one of the areas where enrollment is ongoing. See our dry AMD clinical trials.
It may turn toward AREDS2 supplementation, toward monitoring intervals and the warning signs that should prompt an earlier visit, or toward low vision services that help people make fuller use of the vision they have. You can also read more about age-related macular degeneration and how we approach it.
The one thing we will not do is tell you that nothing can be done, because in our experience that is almost never true.
Find Out Whether Valeda Could Help You
Valeda light therapy is available at our Carlsbad, La Jolla, and Poway locations. If you are seen at our Coronado or Hillcrest office, we can still evaluate you and coordinate treatment at whichever of the three treating locations is most convenient.
Complete the contact form below and our team will review your information and reach out to discuss candidacy, scheduling, and next steps. You can also reach us at 858-451-1911. If your optometrist or ophthalmologist referred you, please let us know so we can send your results back to them.