Improvement of diabetic macular edema after micropulse laser therapy

Abstract

PurposeMicroPulse technology (MP) is a new technique using a subthreshold laser micropulse. The desired effect is to reduce the laser damage to ocular tissue; its application in the macular area is very promising in order to treat diabetic macular edema (DME) with the less retinal damage.We present our 6 months experience with MicroPulse Laser Therapy in DME using a new multifunctional laser, the IRIDEX IQ577.MethodsWe used MP as first‐line therapy in cases of diffuse DME if central macular thickness (CMT) was <300 μm. However, if DME was diffuse and CMT was >400 μm, we began anti‐VEGF therapy to reduce CMT and improve vision as quickly as possible. We began with the laser set in traditional settings. We placed a test spot in a non‐edematous area of the retina and we increased the power up moving to a new area each time, until we note a thermal reaction (white burn). In the second step, we switch the laser to the micropulse setting and perform MP over the area of edema with a high‐density grid treatment.ResultsTen eyes of 8 patients were included. Mean age at diagnosis was 63.5 years. Best‐corrected visual acuity was 0.88 logmar (range 1.7–0.3) before treatment. After three months of MP, it improved to 0.67 logmar (range 1.4–0.2), p: 0.002. CMT was 367 μm, and improved to 316.5 μm (p: 0.14) at 1 month after treatment and to 291.2 μm at 3 months (p: 0.04). OCT detected early retinal reflectivity changes after treatment. All patients reported subjective improvement. No adverse events were observed during follow‐up.ConclusionsMP laser is an effective laser to treat DME. Moreover, the attractive safety profile of MP treatment allows clinicians to offer earlier treatment to prevent tissue damage and the development of visual disability.