Table 4.

Studies on MPLT and conventional laser.

Article	Design	Evaluated on	Results
Vujosevic et al., 2010 [61]	Prospective, randomized 810 nm MPLT (125 μm/200 ms/5% DC/fixed 750 mW) vs. 514 nm mETDRS photocoagulation (100 μm/100 ms/80–100 mW)	62 eyes naïve CI-DME CRT ≥ 250 μm FU = 12	Stable BCVA in both groups. Similarly significant decrease in CRT in both groups. Significant increase in central 12° retinal sensitivity in MPLT group and significant decrease in ETDRS group. Mean no. of treatment 2.03 ± 0.75 in MPLT vs. 2.1 ± 1 in mETDRS.
Lavinsky et al., 2011 [62]	Prospective, randomized, double-masked 810 nm ND-MPLT vs. 810 nm HD-MPLT (125 μm/300 ms/15% DC/titrated to 1.2× CWL power) vs. 532 nm mETDRS photocoagulation (75 μm/50 ms/barely visible)	123 patients naïve CS-DME CRT ≥ 250 μm FU = 12	Best improvement in BCVA in HD-MPLT group (logMAR 0.25); stable BCVA in ND-MPLT group. Significant progressive reduction in CRT in all groups; greatest in HD-MPLT group (154 μm). No statistical differences in BCVA and CRT in HD-MPLT and mETDRS group. No retreatment in 49% HD-MPLT, 44% mETDRS, and 2% ND-MPLT.
Venkatesh et al., 2011 [63]	Prospective, randomized 810 nm MPLT (125 μm/2000 ms/5% DC/titrated to 0.5× CWL power) vs. 532 nm conventional laser (50–100 μm/100 ms/90–180 mW)	46 eyes CS-DME CRT < 400 μm FU = 6	Stable BCVA, macular sensitivity, and contrast sensitivity in both groups. Similarly significant decrease in CRT in both groups. More regions with functional loss in mfERG detected after conventional laser.
Inagaki et al., 2012 [64]	Retrospective, case-series Grid photocoagulation 810 nm MPLT (200 μm/200 ms/15% DC, titrated to 2–3× CWL power) vs. multicolor (532, 561, or 569 nm) laser (100 μm, 100 ms, 50–100 mW) vs. 532 nm pattern scanning laser (100 μm, 20 ms, 120–320 mW)	30 eyes CS-DME (n = 15) BRVO (n = 15) FU = 6	No damage was identified after MPLT in OCT scans; fewer changes in outer retina after pattern scanning laser than after conventional laser.
Xie et al., 2013 [65]	Prospective, randomized 810 nm MPLT (125 μm/300 ms/5% DC, titrated to 0.5× visible MPLT power) vs. argon ion conventional laser	99 eyes DME FU = 6	Stable BCVA and significant decrease in CRT in both groups. No significant differences in BCVA and CRT between groups.
Othman et al., 2014 [66]	Prospective 810 nm MPLT (75–125 μm/15% DC/800–1000 mW) Primary treatment vs. secondary treatment after argon laser photocoagulation	220 eyes CS-DME CRT > 210 μm FU = 14 ± 2.8	Stable BCVA in both groups. Significant decrease in CRT in both groups. In primary treatment, 11.37% of eyes and 33% of them in secondary treatment required intravitreal triamcinolone; 3.2% of them in primary group required vitrectomy due to poor response.
Fazel et al., 2016 [67]	Prospective, randomized, single-blind 810 nm MPLT (75–125 μm/0.3 ms/15% DC/1000 mJ) vs. 810 nm focal + grid conventional laser	68 eyes naïve CS-DME CRT 300–450 μm FU = 4	Significant improvement in BCVA only in MPLT group. Significant decrease in CRT in both groups; more significant in MPLT group.
Chhablani et al., 2018 [68]	Prospective, randomized, double-masked 577 nm 5% DC vs. 577 nm 15% DC (100 μm/100 ms/titrated to 0.3× visible MPLT power) vs. 532 nm navigated mETDRS photocoagulation.	30 eyes naïve non-CI-DME CRT < 350 μm FU = 3	Stable BCVA and CRT in all groups. Significant reduction in retinal sensitivity in conventional group; similarly significant increase in 5% DC and 15% DC groups.
Bougatsou et al., 2020 [69]	Prospective, randomized 532 nm MPLT (50–100 μm/100 ms/15% DC/titrated to 2× CWL power) vs. 532 nm focal photocoagulation	60 eyes non-CI-CS-DME naïve FU = 6	Significantly reduced CRT in both groups; significantly better in MPLT group. Significant improvement in BCVA in MLPT group.
Al-Barki et al., 2021 [70]	Prospective short-pulse subthreshold 532 nm vs. micropulse 810 nm	116 eyes CI-DME FU = 6	Visual acuity significantly improved in MLPT group. Comparable anatomic results and need for rescue therapy in both groups.
Lois et al., 2022 [71,72]	Prospective, randomized, double-masked DIAMONDS trial 577 nm MPLT (125 μm/300 ms, 15% DC, titrated to 1× CWL power) vs. mETDRS photocoagulation	266 eyes CI-DME CRT 301–399 μm FU = 24	No difference in BCVA, CRT, or 10-2 visual field; need for additional rescue treatment. No. of laser treatments was higher in MPLT group (2.37 vs. 1.89).

MPLT, micropulse laser treatment; mETDRS, modified Early Treatment Diabetic Retinopathy Study; CWL, continuous-wave laser; CI, center involved; DME, diabetic macular edema; BCVA, best corrected visual acuity; CRT, central retinal thickness; FU, follow-up (in months); ND, normal density; HD, high density; CS, clinically significant; mfERG, multifocal electroretinography; DC, duty cycle.