Subthreshold micropulse laser versus intravitreal antiVEGF for diabetic macular edema patients with relatively better visual acuity

AIM: To compare the effects of yellow（577 nm） subthreshold micropulse laser（SML） and intravitreal（IV） anti-vascular endothelial growth factor（VEGF） treatment in patients with diabetic macular edema（DME） with relatively better visual acuity [best corrected visual acuity（BCVA） ≤0.15 log MAR].METHODS: The medical records of 76 eyes of 47 patients underwent IV（0.5 mg） anti-VEGF injection or SML for the DME with relatively better BCVA were reviewed. The IV group received three consecutive monthly IV anti-VEGF injections, then were retreated as needed. The laser treatment group was treated at baseline and 3 mo, and then retreated at 6 and 9 mo if needed. All participants were followed up for one year. The mean BCVA and mean central macular thickness（CMT） values changes over the follow-up were evaluated.RESULTS: Twenty-four and 23 patients were assigned to the SML and IV subgroups, respectively. The mean number of treatments was 3.64±0.76 in SML group and 5.85±1.38 in IV group（P<0.05）. The subgroups were similar with regard to the mean BCVA score at baseline and at the 1;and 3;months, but the score of SML group was better than that of IV group at the 6;, 9;, and 12;months（P<0.05）. The decrease in the mean CMT values from baseline values was higher in SML group at the 6;, 9;, and 12;months（P<0.05）.CONCLUSION: Yellow SML treatment is superior to IV anti-VEGF injection in DME patients with relatively better BCVA for increasing visual acuity and decreasing CMT at 6, 9, and 12 mo. SML can be a good alternative first-line therapy for DME with BCVA ≤0.15 log MAR.