Response to subthreshold micropulse laser treatment in the prophylaxis of diabetic macular oedema: A preliminary study
Year: 2025
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: PURPOSE: To evaluate the use of subthreshold micropulse laser (SMPL) in the prevention and management of mild diabetic macular oedema (DME). METHODS: This prospective, randomised and sham-controlled study included 159 eyes (123 patients) with diabetic retinopathy, central retinal thickness (CRT) ≤ 325 μm, and best-corrected visual acuity (BCVA) ≥ 80 ETDRS letters. The participants were assigned to either SMPL treatment (n = 103) or sham therapy (n = 56). Ophthalmic evaluations were performed at baseline (T1), 3 months (T2) and 12 months (T3) to assess BCVA and optical coherent tomography (OCT) parameters, including CRT, macular thickness (MT), macular volume (MV), and hyperreflective spots (HRS). RESULTS: In the SMPL group, BCVA improved after 3 months (T2 > T1; p = 0.002); MT decreased after 12 months (T2, T1 > T3; p < 0.001); MV decreased after 12 months (T2, T1 > T3; p < 0.001); HRS count decreased after 3 and 12 months (T1 > T2, T3, p < 0.001). The decrease in CRT after 3 months was greater in the SMPL group (p = 0.003). The need for rescue therapy was lower in the SMPL group (9.7% vs. 19.6%, p = 0.007). BCVA, CRT, MV, MT and HRS remained stable in the sham group, while microaneurysms count was stable in both groups. CONCLUSION: SMPL is safe and effective for the prophylaxis of mild DME, as it reduces MT and MV while keeping BCVA stable. The decreased need for rescue anti-vascular endothelial growth factor therapy suggests that it may delay or reduce intravitreal injections.
Source: Acta Ophthalmologica
DOI: 10.1111/aos.17548
Authors: Barbara Sabal, Edward Wylęgała, Sławomir Teper
Institutions: Medical University of Silesia, John Paul II Hospital
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4411758175