Focal macular laser

Focal laser photocoagulation was the first treatment proven effective for reducing diabetic macular edema established by the Early Treatment Diabetic Retinopathy Study (ETDRS). The purpose of focal laser photocoagulation is to reduce the progression of diabetic macular edema and to stabilize visual function. Focal laser treatment is targeted at leaking microaneurysms identified by fluorescein angiography or by fundoscopic exam over areas of retinal thickening. Grid pattern photocoagulation can be applied over areas of diffuse leakage. Since the early 2000s, intravitreal injections of anti-vascular endothelial growth factor (VEGF) have revolutionized the management of diabetic macular edema. The treatment of diabetic macular edema often involves a multimodal approach combining the use of intravitreal anti-VEGF injections, with or without focal laser treatment, with or without intravitreal steroid injections.