The present manuscript stems from evidence, which indicates that specific wavelength produce an activation of the autophagy pathway in the retina. These effects were recently reported to synergize with the autophagy-inducing properties of specific phytochemicals. The combined administration of photo-modulation and phytochemicals was recently shown to have a strong potential in eliciting the recovery in the course of retinal degeneration and it was suggested as a non-invasive approach named "Lugano protocol" to treat age-related macular degeneration (AMD). Recent translational findings indicate that the protective role of autophagy may extend also to acute neuronal injuries including traumatic neuronal damage. At the same time, very recent investigations indicate that autophagy activation and retinal anatomical recovery may benefit from sound exposure. Therefore, in the present study, the anatomical rescue of a traumatic neuronal loss at macular level was investigated in a patient with idiopathic macular hole by using a combined approach of physical and chemical non-invasive treatments. In detail, light exposure was administered in combination with sound pulses to the affected retina. This treatment was supplemented by phytochemicals known to act as autophagy inducers, which were administered orally for 6 months. This combined administration of light and sound with nutraceuticals reported here as Advanced Lugano's Protocol (ALP) produced a remarkable effect in the anatomical architecture of the retina affected by the macular hole. The anatomical recovery was almost complete at roughly one year after diagnosis and beginning of treatment. The structural healing of the macular hole was concomitant with a strong improvement of visual acuity and the disappearance of metamorphopsia. The present findings are discussed in the light of a synergism shown at neuronal level between light and sound in the presence of phytochemicals to stimulate autophagy and promote proliferation and neuronal differentiation of retinal stem cells.

中文翻译：

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视网膜中的光和声音脉冲与营养品相结合可以促进中央凹孔的恢复。

本手稿源于证据，这表明特定波长会激活视网膜中的自噬途径。最近有报道称，这些作用与特定植物化学物质的自噬诱导特性协同作用。最近显示，光调节和植物化学物质的联合给药在促进视网膜变性过程中恢复方面具有强大的潜力，并被建议作为一种名为“Lugano 方案”的非侵入性方法来治疗年龄相关性黄斑变性。 AMD）。最近的转化研究结果表明，自噬的保护作用也可能延伸到急性神经元损伤，包括创伤性神经元损伤。同时，最近的研究表明，自噬激活和视网膜解剖恢复可能受益于声音暴露。因此，在本研究中，采用物理和化学无创治疗相结合的方法，对一名特发性黄斑裂孔患者的黄斑水平创伤性神经元丢失的解剖抢救进行了研究。详细地，将光照射与声音脉冲结合到受影响的视网膜上。这种治疗辅以已知作为自噬诱导剂的植物化学物质，口服给药 6 个月。这种将光和声音与营养保健品相结合的方法在此报告为高级卢加诺协议 (ALP)，对受黄斑裂孔影响的视网膜的解剖结构产生了显着影响。在诊断和开始治疗大约一年后，解剖学恢复几乎完成。黄斑裂孔的结构愈合伴随着视力的强烈提高和变形的消失。本研究结果是根据在存在植物化学物质的情况下在神经元水平上显示的光和声音之间的协同作用来讨论的，以刺激自噬并促进视网膜干细胞的增殖和神经元分化。