AI Article Synopsis
- The study introduces subthreshold micropulse diode laser (SMPL) as an effective, safe, and cost-efficient treatment for diabetic macular edema (DME), highlighting its ability to selectively target retinal cells and reduce inflammation.
- A literature review from 2000 to 2023 presents evidence that SMPL produces similar long-lasting effects as traditional laser treatments without significant differences in efficacy across various wavelengths, although factors like HbA1c levels and central macular thickness may impact results.
- The research concludes that combining SMPL with anti-VEGF injections can minimize the number of required treatments while maintaining effectiveness, but notes the absence of standardized protocols and the need for further investigation into specific treatment challenges.
Article Abstract
Purpose: To introduce the treatment of diabetic macular edema (DME) with subthreshold micropulse diode laser (SMPL), to summarize the biological impact, therapeutic effects, and safety of this treatment, and to discuss the response to DME when SMPL is combined with anti-vascular endothelial growth factor (anti-VEGF) or steroid.
Methods: The literature search was performed on the PubMed database, with a selection of English-language articles published from 2000 to 2023 with the following combinations of search terms: diabetes macular (o) edema, micropulse laser or subthreshold micropulse laser, anti-vascular endothelial growth factor, and steroid.
Results: SMPL is a popular, invisible retinal laser phototherapy that is inexpensive, safe, and effective in the treatment of DME. It can selectively target the retinal pigment epithelium, reduce the expression of pro-inflammatory factors, promote the absorption of macular edema, and exert a similar and lasting clinical effect to traditional lasers. No significant difference was found in the therapeutic effects of SMPL between different wavelengths. However, HbA1c level and pretreatment central macular thickness (CMT) may affect the therapeutic outcomes of SMPL.
Conclusion: SMPL has a slow onset and produces lasting clinical effects similar to conventional photocoagulation. It has been reported that SMPL combined with the intravitreal anti-VEGF injection can significantly reduce the number of injections without influencing the therapeutic effect, which is essential for clinical applications and research. Although 577 nm SMPL is widely used clinically, there are no standardized protocols for SMPL. Additionally, some important problems regarding the treatment of SMPL require further discussion and exploration.
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