Laser-Based Therapy Approaches in the Retina: A Review of Micropulse Laser Therapy for Diabetic Retinopathy

Ines Nagel; Arthur Mueller; William R. Freeman; Igor Kozak

doi:10.1055/a-2418-5173

Klinische Monatsblätter für Augenheilkunde, Table of Contents

Klin Monbl Augenheilkd 2024; 241(11): 1201-1206
DOI: 10.1055/a-2418-5173

Übersicht

Laser-Based Therapy Approaches in the Retina: A Review of Micropulse Laser Therapy for Diabetic Retinopathy

Laserbasierte Therapieansätze für die Netzhaut: ein Überblick über die Mikroimpuls-Lasertherapie bei diabetischer Retinopathie

Authors

Ines Nagel

¹Jacobs Retina Center, University of California San Diego, La Jolla, California, United States
Arthur Mueller

²Ophthalmology, University Hospital, Augsburg, Germany
William R. Freeman

¹Jacobs Retina Center, University of California San Diego, La Jolla, California, United States
Igor Kozak

³Ophthalmology, Moorfields Eye Hospital Dubai, Abu Dhabi, United Arab Emirates

Abstract

Purpose This review aims to elucidate the mechanisms and clinical utility of subthreshold micropulse laser (SML) therapy in the context of retinal care. Subthreshold or “nondestructive” laser therapy encompasses treatment modalities that induce minimal or no harm to retinal or choroidal tissue and leave no visible sings post-application, while achieving clinical efficacy.

Methods A comprehensive review of literature sourced from databases including PubMed, Medline, Embase, Cochrane, and Web of Science was conducted, focusing on articles published before February 2024, and discussing the contemporary use of SML therapy in treating diabetic retinopathy (DR).

Results The review presents evidence from scientific literature supporting SML therapy as a viable therapeutic approach for management of DR. Across numerous studies, SML therapy has demonstrated safety and additional therapeutic efficacy without causing damage to underlying retinal tissue.

Conclusion Subthreshold laser treatment emerges as a safe strategy for addressing DR. Numerous studies have shown its additional efficacy to anti-VEGF pharmacotherapy, which is the currently approved monotherapy for complications of DR. Ongoing research and clinical investigations aim to further elucidate the mechanisms and optimize the therapeutic advantages of this technology.

Zusammenfassung

Zielsetzung Ziel dieser Übersicht ist es, die Mechanismen sowie den klinischen Nutzen des Einsatzes von Nanolasern im Rahmen der Netzhautbehandlung zu untersuchen. Eine Therapie mit Nanolaser (auch Subthreshold-Micropulse-Laser bzw. SML genannt) umfasst klinisch wirksame Behandlungsmethoden, die Netzhaut- und Aderhautgewebe so schonen, dass schlimmstenfalls minimale Schäden verursacht werden. Es bleiben nach der Behandlung keine sichtbaren Spuren zurück.

Methoden In diese Übersicht wurden hauptsächlich Artikel mit Veröffentlichungsdatum vor Februar 2024 einbezogen, die den aktuellen Einsatz von Nanolasern zur Behandlung der diabetischen Retinopathie (DR) beschreiben. Als Quelle diente eine umfassende Literaturrecherche mittels Datenbanken wie PubMed, Medline, Embase, Cochrane und Web of Science.

Ergebnisse Diese Übersicht präsentiert Nachweise aus der wissenschaftlichen Literatur, die den Einsatz von Nanolasern als effektiven Therapieansatz zur Kontrolle einer diabetischen Retinopathie unterstützen. In zahlreichen Studien hat sich gezeigt, dass der Einsatz eines Nanolasers eine sichere Behandlungsmethode mit zusätzlicher therapeutischer Wirksamkeit darstellt, die gleichzeitig das darunterliegende Netzhautgewebe effektiv schont.

Schlussfolgerung Der Einsatz des Nanolasers hat sich als effektive Strategie zur schonenden Behandlung der diabetischen Retinopathie erwiesen. Die zusätzliche Wirksamkeit wurde im Vergleich zur Anti-VEGF-Pharmakotherapie, die derzeit als zugelassene Monotherapie bei Folgeerscheinungen der DR gilt, durch zahlreiche Studien belegt. Weitere Forschung und klinische Untersuchungen sollen die Mechanismen näher beleuchten, um die therapeutischen Vorteile dieser Technologie zu optimieren.

Keywords

retina - retinal laser - micropulse laser - diabetic retinopathy

Schlüsselwörter

Retina - Netzhaut-Laser - Mikroimpuls-Laser - diabetische Retinopathie

Full Text

References

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