Laser remains standard of DME therapy


Combination therapy also showing promise

The International Diabetes Federation estimates that in the European countries of Austria, France, Germany, Italy, Portugal and Spain there are 22.1 million people currently living with diabetes, and the Center for Disease Control and Prevention estimates that 25.8 million Americans also have the disease. As the global population continues to age, there is increasing pressure for treatments that are both clinically effective and economically efficient. Advances in laser treatment protocols allow it to meet both of these criteria, and combined therapies are showing promise as well.

The evolution of laser photocoagulation

The packet of photons in each micropulse contains much less energy than a whole pulse. When the train of micropulses reaches the target tissue, thermal elevation and its diffusion from the impact zone are limited significantly. The result is that the sublethal treatment affects only a small collection of retinal epithelial cells and just the tips of the photoreceptors, as opposed to the large crater created with standard continuous-wave laser therapies. In essence, the visible burn has been eliminated.

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Josefina Botta, MD, MSc, at ASCRS 2024
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