Diabetic macular edema (DME) is the leading cause of blindness in the diabetic population. The diabetes Control
and Complications Trial reported that 27% of patients affected by type 1 diabetes develop DME within 9 years of onset.
Other studies have shown that in patients with type 2 diabetes, the prevalence increased from 3% to 28% within 5
years of diagnosis to twenty years after the onset. At the present time, despite the enthusiasm for evaluating several new
treatments for DME, including the intravitreal therapies for DME (e.g., corticosteroids, and anti-VEGF drugs), laser photocoagulation
remains the current gold standard and the only treatment with proven efficacy in a wide range of clinical trials
for this condition. Despite being the standard technique for comparison and evaluation of the emerging treatments, we
have generally poor understanding of the ETDRS recommendations, and we often forget about the results of laser in
DME. The purpose of this review is to update our knowledge on laser photocoagulation for DME with an extensive review
of the ETDRS results and discuss the laser techniques. Furthermore, we will describe the new developments in laser
systems and review the current indications and results. Finally, we will discuss the results of laser treatments versus the
current pharmacological therapies. We conclude by trying to provide a general overview that which laser treatment must
be indicated and what types of lasers are currently recommended.
Keywords: Laser, grid laser, focal laser, pan-retina-photocoagulation, anti-VEGF injections, diabetic retinopathy, diabetic
macular edema, clinically significant macular edema, diffuse macular edema, focal macular edema.
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