Can TMS Help Vision in Severe Retinal Degenerative Disease?

Why Would Brain Stimulation Affect Vision?

Vision depends on both the eye and the brain. The retina converts light into neural signals, but those signals must then be processed through the visual pathways and visual cortex. In advanced retinal degeneration, damage to photoreceptors can be irreversible, yet the brain’s visual networks may still retain some capacity for plasticity.

The investigators proposed that stimulating the occipital visual cortex could enhance cortical excitability and functional connectivity, potentially improving how remaining visual information is processed. They described this concept as a possible “roundabout rescue” strategy—working through the brain rather than repairing the retina itself.

This is an important distinction: TMS does not regenerate photoreceptors, reverse the underlying genetic disease, or repair structural retinal damage.

What Did the 2026 Study Test?

The prospective, non-randomized, parallel-arm pilot study was conducted at the Eye & ENT Hospital of Fudan University in Shanghai and was an exploratory subgroup analysis of a registered clinical trial.

• Participants were 30 to 80 years old with severe bilateral myopic macular degeneration or severe retinitis pigmentosa.
• The TMS group received five consecutive daily sessions targeting both sides of the occipital visual cortex.
• Each daily session used theta-burst stimulation consisting of bursts of three 50-Hz pulses every 200 milliseconds, for a total of 600 pulses.
• The primary outcomes were change in best-corrected visual acuity (BCVA) and visual field at four weeks.
• Secondary assessments included contrast sensitivity, macular sensitivity, fixation stability, and patient-reported visual-function questionnaires.
• Ten participants completed resting-state fMRI before and after treatment to explore possible cortical changes.

What Improvements Were Reported?

Compared with the control group, patients receiving TMS showed statistically greater short-term improvement in several visual measures.

• Patients saw more clearly. On average, both the myopic macular degeneration and retinitis pigmentosa groups showed measurable improvement in their ability to see details on a standard vision test.
• Patients could detect more within their visual field. Testing showed improvement in the areas of vision that had previously been reduced or absent.
• Contrast sensitivity and macular sensitivity improved over the four-week observation period.
• Fixation stability improved in the myopic macular degeneration cohort.
• Patient-reported visual function improved in several domains, including some measures of near vision, overall vision, mental health, social function, and dependence.

These changes are clinically interesting, but they should not be interpreted as evidence that TMS restored normal vision or reversed retinal degeneration.

What Did the Brain Imaging Show?

In the small fMRI subgroup, the investigators reported increased activity in visual-related cortical regions after TMS, including the calcarine cortex, cuneus, lingual gyrus, and other occipital regions. They also observed stronger functional connectivity among visual regions and between the visual network and the default-mode network.

Some imaging changes correlated with improvement in visual acuity. However, only 10 participants were included in the fMRI analysis. These findings are useful for generating hypotheses about the mechanism, but they cannot establish that the brain changes caused visual improvement.

How Long Did the Benefit Last?

The study followed visual outcomes for only four weeks after treatment. The authors reported that improvements observed after treatment persisted at the four-week endpoint, but the study does not establish whether benefits persist for months or years.

Longer follow-up studies are needed before patients can be given reliable expectations about durability or whether maintenance TMS would be useful.

How Safe Was TMS in This Study?

No treatment-related adverse events were reported during the study’s follow-up period. The investigators specifically monitored for ocular symptoms, including transient visual disturbances, periocular discomfort, and muscle twitching, as well as systemic effects, including headache, scalp discomfort, dizziness, and seizures.

This is reassuring, but the absence of treatment-related adverse events in a pilot study does not prove that the protocol is risk-free. Larger studies are needed to better characterize safety, particularly in patients with advanced eye disease.

Why the Results Need to Be Interpreted Carefully

The authors themselves emphasized that the findings are hypothesis-generating. Several aspects of the study limit the strength of the conclusions:

• The study was not randomized.
• Participants were assigned to treatment or control based on clinical indication and physician judgment.
• There was no sham-TMS control group, so placebo and expectation effects cannot be excluded.
• The analyzed sample included 88 patients, making this a relatively small exploratory study.
• Only 10 participants underwent the paired fMRI analysis.
• Follow-up was limited to four weeks.
• The study evaluated two specific retinal degenerative diseases—myopic macular degeneration and retinitis pigmentosa—and the findings should not automatically be applied to other causes of visual loss.

The investigators concluded that larger randomized, sham-controlled, masked trials with longer follow-up are required.

Is TMS FDA Cleared for Retinitis Pigmentosa or Myopic Macular Degeneration?

No. Transcranial magnetic stimulation is not currently FDA-cleared for the treatment of retinitis pigmentosa, myopic macular degeneration, or retinal degenerative disease. Using TMS to improve vision in these conditions would therefore constitute an off-label use of a TMS device in the United States.

Could TMS Become Part of Future Vision-Rehabilitation Strategies?

Potentially. The concept is scientifically interesting because it focuses on cortical plasticity rather than attempting to repair the retina itself. If future randomized trials reproduce the results, TMS could eventually be studied alongside retinal gene therapy, cell-based treatments, low-vision rehabilitation, visual prostheses, and other emerging approaches.

At present, however, the evidence is too preliminary to position occipital TMS as a substitute for ophthalmologic care, retinal specialty treatment, genetic evaluation, or established low-vision rehabilitation.

What This Could Mean for BrainHealth Solutions

BrainHealth Solutions has experience with transcranial magnetic stimulation and neuromodulation. The new study provides a scientifically interesting framework for evaluating whether visual-cortex stimulation could eventually become part of the treatment for selected patients with severe retinal disease, in collaboration with the patient’s ophthalmologist or retinal specialist, with objective baseline and follow-up visual testing.

Who Might Be Considered for Future Evaluation?

The published pilot study focused on adults with severe myopic macular degeneration or retinitis pigmentosa. That does not mean that every patient with these conditions is an appropriate candidate for TMS.

An informed evaluation would need to consider:

• Confirmed retinal diagnosis and disease severity
• Current retinal and ophthalmologic treatment options
• Baseline visual acuity and visual-field testing
• Neurological and psychiatric history
• History of seizures or conditions that may increase seizure risk
• Implanted metallic or electronic devices
• Current medications
• Ability to complete standardized visual testing and follow-up

Frequently Asked Questions

Can TMS restore vision lost from retinitis pigmentosa?

The new study reported short-term improvements in visual function in patients with retinitis pigmentosa, but it does not show that TMS regenerates the retina or permanently restores lost vision. The findings need confirmation in randomized sham-controlled trials.

Did patients with myopic macular degeneration also improve?

Yes. In the pilot study, patients with severe myopic macular degeneration who received TMS showed greater short-term improvements than controls in visual acuity, visual field, contrast sensitivity and macular sensitivity.

Where was the brain stimulated?

The protocol targeted both sides of the occipital visual cortex—the posterior part of the brain responsible for processing visual information.

How many treatments were used?

The study used five consecutive daily sessions. This was a research protocol and should not be interpreted as an established standard course of treatment for retinal disease.

Was the treatment safe?

No treatment-related adverse events were reported during the short follow-up period. Larger and longer studies are still needed to establish the safety profile for this specific indication.

Is this treatment FDA-approved for retinal disease?

No. TMS is not FDA-cleared specifically for myopic macular degeneration, retinitis pigmentosa, or retinal degeneration. Use for these conditions would be off-label or investigational in the United States.

Should TMS replace treatment from my retinal specialist?

No. TMS should not replace retinal evaluation, genetic counseling, or testing when appropriate, approved retinal therapies, management of complications, or low-vision rehabilitation. Any consideration of TMS for visual impairment should be coordinated with appropriate eye-care specialists.

A Promising Direction—But Still Early

The 2026 British Journal of Ophthalmology pilot study offers an intriguing demonstration of how brain-directed neuromodulation might influence visual function even when retinal damage is severe. Five days of occipital theta-burst TMS were associated with short-term improvements in visual acuity, visual field, contrast sensitivity, macular sensitivity, and several patient-reported outcomes in patients with severe myopic macular degeneration or retinitis pigmentosa.

At the same time, the study was exploratory, non-randomized, lacked a sham control, and had only four weeks of follow-up. The most appropriate conclusion is therefore not that TMS has been proven to restore vision, but that the findings justify rigorous next-generation clinical trials.

Scientific and Regulatory Sources

1. Meng J, Zhang Y, Pei Y, et al. Transcranial magnetic stimulation as a novel therapeutic approach for severe retinal degenerative diseases: a pilot study. British Journal of Ophthalmology. 2026. doi:10.1136/bjo-2025-329114.
2. ClinicalTrials.gov study NCT06612190, the broader prospective study referenced by the authors.
3. U.S. Food and Drug Administration. Repetitive transcranial magnetic stimulation system / transcranial magnetic stimulator device classification information. Current FDA device classifications do not establish retinal degeneration as a cleared TMS indication.