Subthreshold Micropulse Laser Therapy for Retinal Pathology: Age-Related Macular Degeneration and Central Chorioretinal Dystrophy

Background. The role of subthreshold micropulse laser therapy (SMLT) in age-related macular degeneration (AMD) requires critical appraisal. Central chorioretinal dystrophy is considered here in the context of age-related macular degeneration. Objective. To evaluate the biological rationale, clinical findings and limitations of SMLT in AMD. Materials and methods. A targeted narrative review of ten publications from 2015–2025 was conducted. Experimental and clinical findings were synthesized descriptively without meta-analysis; micropulse and nanosecond technologies were distinguished. Results. Experimental studies support activation of cellular stress responses. In a pilot study, the assessed pattern electroretinogram measure improved in 139 of 158 eyes, whereas Snellen visual acuity did not significantly change. Observational studies reported associations with reduced neovascular conversion and slower geographic atrophy enlargement. Their designs limit causal interpretation. Stable visual acuity in eyes with drusenoid pigment epithelial detachment did not exclude progression to late disease. Discussion. Functional responses and anatomical changes cannot be equated with proven prevention of visual loss. Conclusion. SMLT remains an investigational approach for nonexudative AMD. Controlled studies with clinically meaningful long-term outcomes are needed to define its role.

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