Laser photocoagulation in the treatment of diabetic macular edema:a review
Diabetic macular edema(DME)is one of the primary causes of central visual impairment in diabetic patients.Before the advent of anti-vascular endothelial growth factor(anti-VEGF)therapies,laser photocoagulation was the primary intervention for DME.The clinical application of conventional laser photocoagulation in DME has been rel-egated from its erstwhile status as a first-line treatment option due to its potential damage to retinal structures.In recent years,however,with the modifications in laser parameters and operational modalities,novel laser technologies,such as subthreshold micropulse laser photocoagulation and selective retinal therapy,have emerged as promising treatment alterna-tives for DME.The modified lasers selectively target retinal pigment epithelium and cause minimal damage to the neuroepi-thelial tissue,enabling a high safety profile.As an adjunctive therapy to intravitreal anti-VEGF injections,micropulse la-ser therapy offers a dual benefit by maintaining treatment efficacy while reducing the frequency of injections,thereby alle-viating the treatment burden on patients.Moreover,for individuals exhibiting suboptimal responses to anti-VEGF therapy,micropulse laser treatment has demonstrated potential advantages.This article aims to provide a comprehensive overview of the application and recent advancements of macular laser therapy in the management of DME.
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