Subthreshold Micropulse Diode Laser and Double Frequency Neodymium: YAG Laser in Treatment of Diabetic Macular Edema: A Prospective, Randomized Study Using Multifocal Electroretinography

Abstract

SDM laser photocoagulation showed an equally good effect on visual acuity, contrast sensitivity, and reduction of diabetic macular edema (DME) as compared to conventional Nd:YAG laser photocoagulation. MfERG recordings, however, suggest that SDM laser results in better preservation of electrophysiological indices.

Retinal Architecture Recovery After Grid Photocoagulation in Diabetic Macular Edema Observed in Vivo by Spectral Domain Optical Coherence Tomography

“…This is in contrast to what has been described before for subthreshold laser techniques. 14,16,[20][21][22][23] The precise mechanisms of the effects of grid laser treatment in DME are not well understood. It is not clear whether the therapeutic effect, measured as reduced retinal blood flow, is caused by an improvement in retinal tissue oxygenation, 18,24-27 overall reduced retinal tissue, or biochemical changes at the level of the RPE.…”

“…14,16,[20][21][22][23] Hence, a prospective study comparing both, subthreshold PASCAL and micropulse grid laser treatment, is necessary to get more insight into this routinely used treatment modality.…”

Navigierte fokale retinale Lasertherapie mit dem NAVILAS®-System bei diabetischem Makulaödem

“…B. Subthreshold Techniken oder die Einführung von Pat ternLasern [22,27], immer weiter verbes sert. Dennoch wurden die unbestrittenen Vorteile von computergestützter Präzision ("eye tracking"), wie wir sie beispielswei se in der refraktiven Chirurgie seit vielen Jahren erfolgreich anwenden, trotz zahl reicher Ansätze bisher in der retinalen Lastertherapie nicht umgesetzt.…”

Novel Therapies in Development for Diabetic Macular Edema

“…Sub-threshold micropulse laser has been compared to conventional laser photocoagulation using modified ETDRS protocol for patients with DME in randomized controlled trials [35][36][37][38]. Micropulse laser appears to be as effective as conventional laser in treating DME and improving BCVA.…”

“…However, studies using microperimetry have shown that treatment with micropulse laser may increase central retinal sensitivity values compared to conventional laser, which on the contrary, may be associated with worsening of retinal function [36]. Multifocal electroretinogram analyses have shown that patients treated with micropulse laser may have fewer areas of signal void compared to conventional neodymium-doped yttrium aluminum garnet (Nd: YAG) laser photocoagulation [38].…”