Safety of Transfoveal Subthreshold Diode Micropulse Laser for Fovea-Involving Diabetic Macular Edema in Eyes With Good Visual Acuity

Abstract

In a small retrospective series, transfoveal subthreshold diode micropulse laser was safe and effective for the treatment of fovea-involving diabetic macular edema in eyes with good preoperative visual acuity that were not the candidates for conventional photocoagulation or intravitreal injection. Further study is warranted.

Laser Resensitization of Medically Unresponsive Neovascular Age-Related Macular Degeneration

“…6 By the same token, the SDM treatment technique of placing confluent and contiguous SDM spots over the entire area of pathologic examination is informed by our hypothesis that the effects of low-intensity SDM on the RPE are amplified and the clinical effect maximized by high-density treatment application intended to recruit all of the RPE in the diseased area. [6][7][8][9]13,14 (8), then ranibizumab (7), and finally aflibercept (9). A.…”

“…By exclusion, SDM appears to normalize RPE function. [6][7][8][9]13 Thus, we used a standard set of SDM parameters for macular treatment, which was known to be clinically effective without causing laser-induced retinal damage. 6 By the same token, the SDM treatment technique of placing confluent and contiguous SDM spots over the entire area of pathologic examination is informed by our hypothesis that the effects of low-intensity SDM on the RPE are amplified and the clinical effect maximized by high-density treatment application intended to recruit all of the RPE in the diseased area.…”

“…[6][7][8][9]11 After informed consent and pupillary dilation, topical proparacaine was applied to the patient's cornea. A Mainster macular contact lens (magnification factor, ·1.05; Ocular Instruments, Bellevue, WA) was applied with viscoelastic solution.…”

“…[6][7][8][9] The safety of SDM is such that it may be used transfoveally in eyes with 20/20 visual acuity to reduce the risk of visual loss caused by early fovea-involving DME. 9 It has been suggested that SDM works by targeting, preserving, and "normalizing" (moving toward normal) the function of the RPE. 7,8 Tolerance to anti-VEGF medication appears to develop via druginduced disturbance of RPE autoregulation, resulting in altered cytokine expression.…”

“…[6][7][8][9] Subthreshold diode micropulse laser has been reported to be an effective treatment in a number of retinal disorders, including diabetic macular edema (DME), proliferative diabetic retinopathy (DR), macular edema as a result of branch retinal vein occlusion, and central serous chorioretinopathy. [6][7][8][9] The safety of SDM is such that it may be used transfoveally in eyes with 20/20 visual acuity to reduce the risk of visual loss caused by early fovea-involving DME. 9 It has been suggested that SDM works by targeting, preserving, and "normalizing" (moving toward normal) the function of the RPE.…”