Is Laser Still Important in Diabetic Macular Edema as Primary or Deferral Therapy?

Laser treatment was used in the past to reduce the visual loss due to diabetic macular edema. The recent advent of anti-vascular endothelial growth factor (anti-VEGF) has completely revolutionized the management of diabetic retinopathy, with a significant improvement in the overall prognosis. Nevertheless, macular laser can still be applied in selected cases characterized by retinal thickness â ¤400 microns, high visual acuity, extrafoveal location, and contraindications to the intravitreal approach with anti-VEGF and steroids. In addition, the combined therapy with anti-VEGF and macular laser can exploit the synergistic effects of both therapies, leading to a simpler and more practical management of patients over the long-term follow-up.