title: Subthreshold laser therapy for diabetic macular edema: metabolic and safety issues.
abstract: OBJECTIVE
  To review the most important metabolic effects and clinical safety data of subthreshold micropulse diode laser (D-MPL) in diabetic macular edema (DME).
  
  
  METHODS
  Review of the literature about the mechanisms of action and role of D-MPL in DME.
  
  
  RESULTS
  The MPL treatment does not damage the retina and is selectively absorbed by the retinal pigment epithelium (RPE). MPL stimulates secretion of different protective cytokines by the RPE. No visible laser spots on the retina were noted on any fundus image modality in different studies, and there were no changes of the outer retina integrity. Mean central retinal sensitivity (RS) increased in subthreshold micropulse diode laser group compared to standard ETDRS photocoagulation group.
  
  
  CONCLUSIONS
  MPL is a new, promising treatment option in DME, with both infrared and yellow wavelengths using the less aggressive duty cycle (5%) and fixed power parameters. It appears to be safe from morphologic and functional point of view in mild center involving DME.
authors.affiliation: Department of Ophthalmology University of Padova, Padova, Italy.
authors.forename: Stela
authors.initials: S
authors.lastname: Vujosevic
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Martini
authors.forename: Enrica
authors.initials: E
authors.lastname: Convento
authors.forename: Evelyn
authors.initials: E
authors.lastname: Longhin
authors.forename: Olympia
authors.initials: O
authors.lastname: Kotsafti
authors.forename: Raffaele
authors.initials: R
authors.lastname: Parrozzani
authors.forename: Edoardo
authors.initials: E
authors.lastname: Midena
mesh_terms: D003930:Diabetic Retinopathy / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods*; D008269:Macular Edema / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome