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Abstract Background Age-related macular degeneration (AMD) is a leading cause of vision loss. Photobiomodulation (PBM) offers a controversial approach for managing dry AMD, aiming to halt or reverse progression through mitochondrial activity modulation. However, the efficacy and clinical relevance of PBM as a potential approach for managing dry AMD remain debated. Methods We systematically searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) comparing PBM versus a sham in patients with dry AMD. We performed trial sequential analysis (TSA) and minimal clinically important difference (MCID) calculations to assess statistical and clinical significance applying a random-effects model with 95% confidence intervals (CI). Results We included three RCTs comprising 247 eyes. The pooled analysis showed that PBM significant improved BCVA (MD 1.76 letters; 95% CI: 0.04 to 3.48) and drusen volume (MD -0.12 mm³; 95% CI: -0.22 to -0.02) as compared with a sham control. However, the TSA indicated that the current sample sizes were insufficient for reliable conclusions. No significant differences were observed in GA area. The MCID analysis suggested that the statistically significant results did not translate into clinically significant benefits. In the quality assessment, all studies were deemed to have a high risk of bias. Conclusion This meta-analysis points limitations in the current evidence base for PBM in dry AMD treatment, with issues around small sample sizes. Statistically significant improvements do not translate into clinical benefits. The research underscores need for larger RCTs to validate PBM’s therapeutic potential for dry AMD.

Given a hypersurface M on a unit sphere of the Euclidean space, we define the cone based on M as the set of half-lines issuing from the origin and passing through M. By assuming that the scalar curvature of the cone vanishes, we obtain conditions under which bounded domains of such cone are stable or unstable.Dada uma hipersuperfície M de uma esfera unitária do espaço euclidiano, definimos o cone sobre M como o conjunto das semi-retas que saem da origem e passam por M. Admitindo que a curvatura escalar de um dado cone é nula, estabelecemos condições para que os seus domínios limitados sejam estáveis ou instáveis.