This disclosure relates to methods for treatment or prevention of retinal vascular disease by photocoagulation. More specifically, this disclosure relates to an improved technique for the placement of retinal burns so as to prevent the development of hypoxia and progression of ischemia in retinal tissue, including the macula. The methods can also be employed to prevent potential ischemic tissue damage in diabetic, pre-diabetic or other patients with ischemic retinal vascular disease, or those at risk of ischemic retinal vascular disease.