Safety of transfoveal subthreshold diode micropulse laser for fovea-involving diabetic macular edema in eyes with good visual acuity.
OBJECTIVE
To determine the safety of transfoveal subthreshold diode micropulse laser for fovea-involving diabetic macular edema.


METHODS
The records of all patients treated with transfoveal subthreshold diode micropulse laser for fovea-involving diabetic macular edema in two retina clinics were reviewed. The eligibility included fovea-involving diabetic macular edema by spectral domain optical coherence tomography and pretreatment visual acuity of 20/40 or better.


RESULTS
Thirty-nine eyes of 27 patients aged 50 years to 87 years (mean, 69 years) were included. Postoperative follow-up ranged from 3 months to 36 months (mean, 11 months). Fourteen patients were insulin dependent, and 19 had nonproliferative retinopathy. The preoperative visual acuity was 20/20 (10 eyes), 20/25 (10 eyes), 20/30 (8 eyes), and 20/40 (11 eyes). No eye had evidence of laser-induced macular damage by any imaging means postoperatively. There were no adverse treatment effects. Logarithm of the minimum angle of resolution visual acuity was improved on average of 0.03 units at 4 months to 7 months of follow-up (P = 0.0449, paired t-test) and otherwise stable. The central foveal thickness was improved at 4 months to 7 months (P = 0.05, paired t-test) and 8 months to 12 months, postoperatively (P = 0.04, mixed model accounting). Maximum macular thickness was improved at 4 months to 7 months postoperatively (P = 0.01, paired t-test and mixed model accounting).


CONCLUSIONS
In a small retrospective series, transfoveal subthreshold diode micropulse laser was safe and effective for the treatment of fovea-involving diabetic macular edema in eyes with good preoperative visual acuity that were not the candidates for conventional photocoagulation or intravitreal injection. Further study is warranted.
*Private practice, Ventura, California; and †Department of Ophthalmology, Drexel University School of Medicine, Media, Pennsylvania.
Jeffrey K
JK
Luttrull
Stephen H
SH
Sinclair
D000368:Aged; D000369:Aged, 80 and over; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000503:physiopathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D005584:Fovea Centralis; D006801:Humans; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D028022:Low-Level Light Therapy; D008269:Macular Edema / Q000175:diagnosis / Q000503:physiopathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012684:Sensory Thresholds; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology