Abstract
Subthreshold Diode Micropulse (SDM) laser is a relatively new treatment modality that confers very little to no anatomical risk to the retina. However, its efficacy is still being studied, and the scenario where SDM is most useful is still being elucidated. This paper reviews articles from 1997 to 2017 and reviews the settings, results, and outcomes of SDM in various clinical settings including diabetic macular edema, branch retinal vein occlusion, central serous Chorioretinopathy, proliferative diabetic retinopathy, and age-related macular degeneration.
Highlights
HistoryConventional argon retinal photocoagulation has been universally accepted for over forty years [13]
It is primarily used for retinal diseases including proliferative diabetic retinopathy (PDR), diabetic macular edema (DME), choroidal neovascularization, macular edema associated with retinal vein occlusion (RVO), and central serous chorioretinopathy (CSCR) [410]
We examine the role of subthreshold diode micropulse (SDM) laser treatment in retinal diseases
Summary
Conventional argon retinal photocoagulation has been universally accepted for over forty years [13]. Subretinal fluid was eliminated in all eyes by 3 months Their studies suggested that low-intensity/ high-density SDM laser using a 5% duty cycle is a safe and effective modality for treatment of chronic CSCR. Kretz et al performed a comparative, prospective study of SDM versus half-dose verteporfin PDT (hdPDT) versus a control group; his group looked at visual acuity and contrast sensitivity, subretinal fluid changes, and RPE health on fundus autofluorescence (FAF) at week 16 Both treatment groups showed a significantly decreased amount of leakage compared to the control group at week 16 (60% and 66.7% of patients in the SDM and hdPDT group respectively, versus 37.5% in the control group). In a small retrospective study, Luttrull et al performed 810-nm SDM laser in 13 eyes of 12 patients that were deemed unresponsive to anti-VEGF injections One month later, these eyes were re-treated with monthly afilbercept, and 92% (12/13) eyes showed improving foveal thickness with 69% (9/13) having complete resolution in macular exudates [48].
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