Micropulse Laser in Treatment of Initial and Refractory Cases of Center-Involved Diabetic Macular Edema

Inclusion Criteria: * Age ≥18 years. * Both sexes. * Patients with type 1 or 2 diabetes mellitus (DM), best-corrected visual acuity (BCVA) of 20/400 or better, and center-involved DME \[defined as a central macular thickness (CMT) of \>250 but \<700µm measured by spectral-domain optical coherence tomography\]. * Patients with any level of non-proliferative diabetic retinopathy or proliferative diabetic retinopathy with adequate panretinal photocoagulation (PRP) and no signs of disease activity determined by fluorescein angiography (FA). Exclusion Criteria: * Monocular eyes. * Chronic renal failure or renal transplant because of diabetic nephropathy. * Glycated hemoglobin (HbA1c) of more than 10%. * Vitreomacular traction syndrome. * Epiretinal membrane. * PRP within 4months before the treatment. * Intraocular surgery within 6months, including cataract or vitreoretinal operation. * Rubeosis iridis. * Severe glaucoma. * High-risk proliferative diabetic retinopathy. * Poor dilation. * Increased foveal avascular zone. * Any condition that could interfere with optical coherence tomography (OCT) measurement or visual acuity.