Subthreshold Diode Micropulse Laser (SDM) for Persistent Macular Thickening and Limited Visual Acuity After Epiretinal Membrane Peeling.

Abstract

PurposeTo examine the effect of low-intensity/high-density subthreshold diode micropulse laser (SDM) on visual acuity (VA) and macular thickness in eyes with limited visual recovery and persistent macular thickening after epiretinal membrane peeling.MethodsA retrospective review of medical records identified all patients undergoing SDM after membrane peeling in a clinical vitreoretinal subspecialty practice. Exclusion criteria included other obfuscating ocular disease or loss to follow-up after SDM treatment.ResultsAll 19 eyes of 18 patients identified were included for study. After membrane peeling, VA improved from an avg. Snellen 20/240 [logMAR 1.08] to 20/72 [0.56] (p=0.0004). Attributed to persistent macular thickening following membrane peeling, overall VAs then gradually declined to an avg. of 20/91 [0.66] by 4−109 months (avg. 41) post vitrectomy, at which point panmacular SDM was performed. An avg. 15 months post SDM, both VA (to avg. 20/68 [0.53]) and maximum macular thickness improved (p=0.007 and p=0.008, respectively). There were no adverse treatment effects.ConclusionLow-intensity/high-density subthreshold (sublethal) diode micropulse laser (SDM) may reduce macular thickening and improve visual in eyes with persistent macular thickening after membrane peeling even years after vitrectomy.