Purpose: 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
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.
Keywords: Diabetic macular edema, diabetic retinopathy, fluorescein angiography, fundus autofluorescence, microperimetry,
laser treatment, optical coherence tomography, subthreshold micropulse laser, retinal safety.
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