Subthreshold Micropulse Diode Laser Versus Conventional Laser Photocoagulation for Diabetic Macular Edema

Chen, Guohai; Tzekov, Radouil T; Li, Wensheng; Jiang, Fangzheng; Mao, Sihong; Tong, Yuhua

doi:10.1097/iae.0000000000001053

Cited by 66 publications

(66 citation statements)

References 26 publications

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“…Nevertheless, SML might be an option in patients not responding sufficiently to, or who are not able to follow an anti-VEGF therapy (e.g., high costs, compliance problems due to frequent visits for the injections and ophthalmological controls). Chen et al [77] had come to a similar result in their meta-analysis of randomized controlled trials comparing subthreshold micropulse diode laser photocoagulation and conventional laser. They reported a significantly better visual acuity and a similar decrease in CRT after SML compared to conventional laser.…”

Section: Resultsmentioning

confidence: 90%

A Review of Subthreshold Micropulse Laser for Treatment of Macular Disorders

2017

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Micropulse laser treatment is an alternative to the conventional continuous-wave laser for the treatment of retinal or macular diseases. In contrast to the conventional laser, the therapeutic effect of the subthreshold micropulse laser is not accompanied by thermal retinal damage. This fact is of particular importance when a treatment near the fovea is required. Micropulse treatment is applied in indications such as central serous chorioretinopathy (CSC), diabetic macular edema (DME), or macular edema due to retinal vein occlusion (RVO). This review outlines and discusses the published literature of subthreshold micropulse laser treatment for CSC, DME, and macular edema after RVO.

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Section: Resultsmentioning

confidence: 90%

A Review of Subthreshold Micropulse Laser for Treatment of Macular Disorders

2017

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“…[1][2][3][4][5][6] SMPL does not induce protein coagulation, and, therefore, prevents formation of retinal scars and tissue damage. 1,7 Even if SMPL has proven to be an effective treatment for diabetic macular edema (DME), in terms of visual function improvement/stabilization and macular thickness decrease, 3,4,[8][9][10][11][12][13][14][15] the exact mechanism of action is still under investigation. Retinal pigment epithelium (RPE) has been considered the main target with the consequent release of "heat shock proteins" (Hsps), in particular Hsp 70.…”

Section: Introductionmentioning

confidence: 99%

Subthreshold Micropulse Laser in Diabetic Macular Edema: 1-Year Improvement in OCT/OCT-Angiography Biomarkers

Vujosevic

Toma

Villani

et al. 2020

Trans. Vis. Sci. Tech.

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The aim of this study was to evaluate 1-year quantitative changes in specific inflammatory parameters on optical coherence tomography (OCT) / optical coherence tomography angiography (OCTA) in diabetic macular edema (DME) treated with subthreshold micropulse laser (SMPL). Methods: Thirty-seven patients / eyes with previously treatment-naïve DME treated with SMPL were prospectively evaluated at 3, 6, and 12 months. Fifteen fellow eyes with only microaneurysms (MAS) not eligible for treatment were controls. Evaluated OCT / OCTA parameters included: central macular thickness (CMT); hyper-reflective retinal spots (HRS); disorganization of inner retinal layers (DRILs); MA in the superficial / deep capillary plexuses (SCP/DCP); cysts in the area at the SCP / DCP; and macular perfusion parameters (MATLAB, version 2017b). Results: In the treated group, mean best corrected visual acuity (BCVA) progressively increased from 69.4 ± 12.0 to 76.0 ± 9.1 Early Treatment Diabetic Retinopathy Study (ETDRS) letters (P < 0.001) at 12 months; HRS decreased from baseline (80.75 ± 20.41) at 3 (73.81 ± 17.1, P = 0.002), 6 (69.16 ± 16.48, P < 0.0001), and 12 months (66.29 ± 18.53, P < 0.0001). MA decreased at 3 months in the DCP (P = 0.015), at 6 and 12 months in both plexuses (P ≤ 0.0007). BCVA, HRS, and MA remained stable in the controls during all follow-ups. DRIL was present in 18 of 37 patients at baseline and progressively decreased from 557.0 ± 238.7 to 387.1 ± 282.1 μm (P = 0.01). The area of cyst decreased both in the SCP (P = 0.03) and the DCP (P = 0.02). CMT and perfusion parameters did not change. Conclusions: SMPL reduced the number of HRS (sign of activated microglia cells in the retina), MA, DRIL extension, and the area of cysts. Further studies are needed to confirm these preliminary data on the anti-inflammatory effect of SMPL, and to explore the mechanism of action. Translational Relevance: The follow-up of OCT/OCTA noninvasive biomarkers offers a unique insight in the mechanism of laser action, suggesting an anti-inflammatory effect of SMPL.

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“…Nach einer Behandlung mit einem gelben Mikropulslaser (577 nm, Iridex IQ, 5 % Duty Cycle, 0,2 sm 250 MW) wurde nach 3 Monaten eine positive Änderung im tiefen Kapillarplexus beobachtet (Iridex, Mannheim, Deutschland) [251]. Wenige randomisierte Studien haben ein ähnliches funktionelles und anatomisches Ansprechen im Vergleich zu konventionellen Lasern gezeigt, obwohl nach der Behandlung mittels Subthreshold-Laser unter Umständen mehr Zeit bis zur Resorption der Flüssigkeit verstreichen dürfte [252,253].…”

Section: 1-2 Ivom-therapie Mit Steroidenunclassified

Stellungnahme der DOG, der RG und des BVA zur Therapie des diabetischen Makulaödems

2020

Klin Monatsbl Augenheilkd

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Subthreshold Micropulse Diode Laser Versus Conventional Laser Photocoagulation for Diabetic Macular Edema

Cited by 66 publications

References 26 publications

A Review of Subthreshold Micropulse Laser for Treatment of Macular Disorders

A Review of Subthreshold Micropulse Laser for Treatment of Macular Disorders

Subthreshold Micropulse Laser in Diabetic Macular Edema: 1-Year Improvement in OCT/OCT-Angiography Biomarkers

Stellungnahme der DOG, der RG und des BVA zur Therapie des diabetischen Makulaödems

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