Laser still useful diabetic eye disease tool in anti-VEGF era
Although clinical trial results have advanced anti-VEGF injections to the forefront of treatment for diabetic eye disease, laser photocoagulation continues to be an important modality for the management of diabetic macular edema (DME) and diabetic retinopathy (DR), said Elias Reichel, MD, at the inaugural Retina World Congress.
“Laser for treatment of DME and DR is not dead," said Dr. Reichel, professor and vice chairman, Department of Ophthalmology, Tufts University School of Medicine.
"It still has an important place for treating noncenter-involving DME, and several studies provide support for focal/grid laser in eyes with center-involving DME," he said. "In particular, patients with mild to moderate DME may respond very nicely to laser, and micropulse technology may even allow treatment of patients with fovea-involving disease.”
While panretinal photocoagulation (PRP) may ultimately be supplanted by anti-VEGF therapy for proliferative DR (PDR), data from clinical trials show PRP may still be needed for its treatment in some patients despite their having received aggressive anti-VEGF therapy, he added.
Reviewing the literature relevant to the role of laser in management of diabetic eye disease, Dr. Reichel cited four studies providing evidence supporting its place for treatment of DME: