Comparison of subthreshold diode laser micropulse therapy versus conventional photocoagulation laser therapy as primary treatment of diabetic macular edema

Purpose: The aim of the present study was to investigate the effect of subthreshold diode laser micropulse (SDM) in comparison with conventional laser photocoagulation in the treatment of the diabetic macular edema (DME). Methods: Sixty-eight eyes from 68 patients with clinically significant DME were divided randomly into two equal groups. In the first group, SDM photocoagulation was employed, while conventional laser photocoagulation was performed on the eyes of the second group. Central macular thickness (CMT), central macular volume (CMV), and best corrected visual acuity (BCVA) were measured before, 2, and 4 months after intervention, and the results were compared. Results: The mean CMT was 357.3 and 354.8 microns before the treatment in Groups 1 and 2, respectively (P ¼ 0.85), and decreased significantly to 344.3 and 349.8 after 4 months, respectively (P ¼ 0.012 and P ¼ 0.049). The changes in the central macular thickness was statistically higher in the first group (P ¼ 0.001). The mean CMV significantly decreased in Group 1 (P ¼ 0.003), but it was similar to pretreatment in Group 2 after 4 months (P ¼ 0.31). The BCVA improved significantly in Group 1 (P < 0.001), but it remained unchanged in Group 2 (P ¼ 0.38). Conclusions: In this study, SDM was more effective than conventional laser photocoagulation in reducing CMT and CMVand improving visual acuity in patients with DME.