![]() | Only 14 pages are availabe for public view |
Abstract Subthreshold micro pulse yellow laser showed long-term efficacy in diffuse diabetic macular edema treatment in reducing central macular thickness and improving visual acuity. The level of HbA1c did not correlate significantly with the initial and final macular sensitivity, BCVA and CMT. The SMPLT is safe procedure, because no retinal damage was observed after laser treatment. Morphologic and visual function data reported in this study are adding new insights about safety of yellow MPL treatments in DME. Our study evaluated yellow 577-nm micro pulse laser in patients with DME. There was a statistically significant improvement in VA at follow-up visits, statistically significant decrease of the central macular thickness on OCT, and there was a statistically significant improvement in macular sensitivity at follow-up visits. Our study is one of a few studies to evaluate modifications on OCTA, after SMPL treatment in DME, documenting more pronounced changes in the DCP than in the SCP (decrease in FAZ area, number of MA). A significant decrease in the number of MA in the SCP and DCP occurred as early as 3 months after SMPL. The safety and efficacy profiles of sub threshold micro pulse laser are especially important in the era of intravitreal treatment for DME. In fact, in eyes with mild center-involving DME, or center non involving DME, and with preserved visual acuity. It is essential to avoid morphologic and visual function macular damage, as it always happens with ETDRS laser. Moreover, the use of intravitreal treatment in these patients might not be justified by its potential local and systemic complications. On the other side, the rationale to wait without treatment or lately treated may have a permanent loss of visual acuity or retinal sensitivity. Therefore, the use of non invasive and safe laser treatments may be the most suitable option in specific cases. Therapy using 577-nm laser treatment has several advantages. The cost of 577-nm laser is lower when compared to that of anti-VEGF drugs. Moreover, unlike the traditional 532-nm laser, a yellow wavelength can be repeatedly performed on a macular area. Many patients in the clinic refused to receive anti-VEGF treatment when they knew the high cost. We should at least recommend a laser treatment for them, especially for the ones with low compliance. |