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Update on subthreshold micropulse laser treatment for retinal diseases: A narrative review - PubMed

4 hours ago
  • #laser treatment
  • #ophthalmology
  • #retinal diseases
  • Subthreshold micropulse laser (SML) is an effective alternative to conventional laser treatments for retinal diseases, minimizing tissue damage.
  • SML delivers energy in short bursts with cooling intervals, avoiding visible retinal scarring while triggering therapeutic cellular responses.
  • SML shows comparable outcomes to conventional laser and anti-VEGF therapies in conditions like diabetic macular edema (DME) and central serous chorioretinopathy (CSCR).
  • Benefits of SML include reduced injection burden in DME and improved choriocapillaris perfusion in CSCR.
  • SML may be advantageous in complex cases such as chronic CSCR, pseudophakic macular edema, and dome-shaped maculopathy.
  • Challenges in standardizing SML treatment protocols arise from inconsistencies in laser parameters like wavelength, duty cycle, fluence, and spot size.
  • The 'reset theory' of RPE restoration suggests SML can offer long-term disease control through mechanisms like heat shock protein activation.
  • Larger, high-quality studies are needed to optimize SML treatment settings, improve patient selection, and clarify its role alongside other therapies.