Combining laser and anti-VEGF therapy may improve outcomes in diabetic macular edema
Combining subthreshold micropulse laser (SML) with anti-VEGF therapy is more effective than anti-VEGF monotherapy for certain patients with diabetic macular edema (DME) patients, especially those with baseline central macular thickness (CMT) under 400 µm, by improving visual outcomes and reducing the need for frequent injections, according to a study.
The analysis reviewed 13 studies including 405 eyes in the experimental group (SML combined with anti-VEGF drugs intravitreal injections) and 400 eyes in the control group (anti-VEGF drugs monotherapy). There was no significant difference in ETDRS visual acuity between groups, but the combined approach led to greater improvements in LogMAR visual acuity at 6 and 12 months (P < 0.05).
Patients with baseline CMT under 400 µm experienced more significant CMT reductions with the combined therapy. The need for annual anti-VEGF injections was notably lower in the group receiving both treatments, potentially easing treatment burden and cost. The SML treatments were administered between 1 and 4 times per year, with only minor side effects reported.
Reference
Jiang Y, He W, Qi S. Evaluating the efficacy of subthreshold micropulse laser combined with anti-VEGF drugs in the treatment of diabetic macular edema: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2025;16:1553311. doi: 10.3389/fendo.2025.1553311. PMID: 40225323; PMCID: PMC11985442.
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