Abstract
Diabetic macular edema is the major cause of decreased vision in diabetic patients. This review explores laser treatment options beyond the established focal/grid laser photocoagulation protocol initially demonstrated in the Early Treatment of Diabetic Retinopathy Study. Subthreshold micropulse laser has been shown to be effective adjunctive therapy in conjunction with intravitreal anti-angiogenic injections in a subset of patients, specifically in those with a retinal thickness of less than 400 μm, without the risk of scotomas and potential vision loss, which can occur with conventional laser. Given the absence of scarring from this “invisible” laser, subthreshold micropulse laser may allow for earlier treatment prior to the onset of clinically significant macular edema, potentially preventing symptomatic vision loss and permanent photoreceptor damage.