Short Pulsed and Low Energy Macular Grid Laser Photocoagulation for Diabetic Macular Edema

Abstract

Purpose: : To determine the anatomical and functional outcome of confluent (high density) and barely visible photocoagulation lesions placed throughout the macula and microaneurysms area in patients with diabetic macular edema (DME)

Methods: : Twenty-eight eyes of 25 patients with DME were treated using a yellow diode laser (586 nm) clinically adjusted to show barely visible photocoagulation lesions at 10 ms exposure time. The mean retinal sensitivity within the central 10 degrees measured with a fundus-related microperimeter, MP1, ETDRS-best corrected visual acuity (BCVA), optical coherence tomography-determined central macular thickness (CMT), and fluorecein angiography (FA) were performed before, 1, 3 and 6 months after a single treatment.

Results: : Central macular thickness decreased by an average of 179 µm. At 6 months main change in visual acuity was 2 letters better. Mean macular sensitivity improved (P<0.005) at 3 and 6 months. Laser lesions were not clinically observed, but detected on FA examination.

Conclusions: : An extensive destruction of retinal tissue with laser burns may not be necessary to achieve an effective laser therapy. In the effort to minimize the side effects while maintaining the efficacy, short pulsed and low energy laser delivery may characterize a more selective alternative to the present standard of care.

Keywords: laser • diabetic retinopathy • macula/fovea