Evangelia Papavasileiou, S. Sivaprasad, S. Liazos, R. Mathew, I. Bisbas (London, UK)

Advantages:

The advantages of this study were to evaluate and compare fundus autofluorescence (FAF) after subthreshold micropulse diode laser versus modified Early Treatment Diabetic Retinopathy Study photocoagulation for clinically significant diabetic macular edema.

Methods:

A prospective series including 20 eyes (20 patients) with untreated, center-involving, clinically significant diabetic macular edema were treated with micropulse laser and compared to historical data on green laser for 20 patients with the same condition. All patients underwent best-corrected visual acuity assessment, slit-lamp biomicroscopy, FAF, optical coherence tomography, and fluorescein angiography at baseline and at 1-, 2-, 3 and 4-month follow-up examinations. Fluorescein angiography was performed at baseline and at 4 months.

Effectiveness / Safety:

Before treatment, demographic and macular parameters were not different between the two treatment groups. At 4 months, best-corrected visual acuity remained stable in both groups, mean central retinal thickness decreased in both groups. There was no significant difference in either best-corrected visual acuity or central retinal thickness between the 2 treatment groups. Fundus autofluorescence never changed in the micropulse diode laser group even after retreatment. In the Early Treatment Diabetic Retinopathy Study group, FAF increased up to 4 months in some patients.

Take home message:

Micropulse diode laser seems to be as effective as modified Early Treatment Diabetic Retinopathy Study laser photocoagulation in the treatment of clinically significant diabetic macular edema with less damage to the retinal pigment epithelium. This data encourages the use of a new, less aggressive laser therapeutic approach in the treatment of clinically significant diabetic macular edema.