Il trattamento fotocoagulativo della maculopatia diabetica può essere effettuato mediante il laser a diodi micropulsato. Con questa metodica l’energia coagulativa impiegata è molto ridotta e il danno tissutale e’ molto meno marcato.
In questo studio su 53 pazienti viene confermata l’efficacia e la sicurezza della metodica.

BCVA è best correct visual acuity, cioè visus migliore raggiungibile con lenti.

Sub-threshold micropulse diode laser photocoagulation as effective as conventional photocoagulation for DME
Researchers prospectively randomized 53 patients (84 eyes) with clinically significant diabetic macular edema to undergo one of the two photocoagulation treatments. Patients were retreated after four months as necessary. After 12 months, laser scars were found in 13.9 percent of eyes that underwent sub-threshold micropulse diode laser photocoagulation compared with 59.0 percent of conventional green laser photocoagulation-treated eyes (P < 0.001). BCVA, contrast sensitivity and retinal thickness were not significantly different between the two groups. British Journal of Ophthalmology, October 2009

Clinical science: Prospective randomised controlled trial comparing sub-threshold micropulse diode laser photocoagulation and conventional green laser for clinically significant diabetic macular oedema

J Figueira, J Khan, S Nunes, S Sivaprasad, A Rosa, J F de Abreu, J G Cunha-Vaz, N V Chong.

British Journal of Ophthalmology
2009;93:10:1341-1344

Abstract Aim: The study was a prospective randomised controlled double-masked trial performed in two centres to compare sub-threshold micropulse diode laser photocoagulation (MPDL) with conventional green laser photocoagulation (CGL) in the treatment of clinically significant diabetic macular oedema (CSMO).

Methods: Fifty-three patients (84 eyes) with diabetic CSMO were randomly assigned to MPDL (n = 44) or CGL (n = 40) according to the modified Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Treatments were performed after baseline and re-treatments were allowed at or after the 4 month visit if necessary. Parameters noted included the best corrected visual acuity (BCVA), colour fundus photographs, central retinal thickness using optical coherence tomography (OCT), vision contrast sensitivity with Pelli–Robson charts and presence of visible laser scars at baseline and at 4 and 12 months. The primary outcome was BCVA at 12 months.

Results: All patients completed 12 months of follow-up after treatment at baseline. There were no statistically significant differences in BCVA, contrast sensitivity and retinal thickness between the two laser modalities at 0, 4 and 12 months. We found that laser scarring was much more apparent with CGL than with the sub-threshold approach (MPDL). Laser scars were identified at the 12 month visits in 13.9% of the MPDL-treated eyes compared with 59.0% of the CGL-treated eyes (p<0.001).

Conclusion: Sub-threshold micropulse diode laser photocoagulation is equally as effective as CGL treatment for CSMO.