Safety and efficacy of the yellow sub-threshold micropulse laser for uveitic macular edema: A pilot study

To assess the safety and efficacy of the yellow sub-threshold micropulse laser (YSML) in eyes with uveitic macula edema (UME).

A prospective interventional study. Eyes with non-infectious UME and an unsatisfactory response to prior conventional treatments underwent navigated YSML (NAVILAS^®). The treatment was planned on an imported macular OCT scan. The central macular thickness (CMT) and best-corrected visual acuity (BCVA) were recorded immediately before the treatment (baseline) and again after 1 and 3 months. The end of the follow up (FU) was the last available evaluation in the case of no UME recurrence; or when the CMT increase required rescue therapy.

Eight eyes of as many patients were included. The mean duration of the FU was 252 days (range: 170-398 days). No adverse events were observed. In the whole cohort the mean values improvement over time was significant for both CMT (p = 0.011) and BCVA (p < 0.001). The indication for a new treatment was stated in 4 eyes (50%) after a mean FU of 277 ± 43 days. This time was statistically comparable with the mean FU of eyes without UME recurrence. At the baseline the non-UME recurrence eyes had a significantly lower mean CMT (326 ± 80 vs 485 ± 112 μm, p = 0.03).

The application of YSLM for UME has not previously been mentioned in literature. Our results were promising in terms of both safety and efficacy. This would authorize further studies on the procedure, also as a first line treatment in naif UME cases.