Transpupillary Thermotherapy – A Novel Modality for Treating Diabetic Maculopathy

Abstract

Abstract: : Purpose: To evaluate the safety and efficacy of Transpupillary Thermoptherapy (TTT) in the management of diabetic subfoveal macula edema. Methods: A pilot observational case series of twenty patients was carried out at Auckland Hospital. Eligible patients had one disc area of diabetic macula edema involving central fovea and best corrected visual acuity (BCVA) between 20/50–20/200. Patients with more than 2 previous conventional macula laser treatments, any retinal laser treatment for diabetes within 3 months, or ocular surgery in the last 6 months in the study eye were excluded. Each patient had an initial assessment followed by TTT (Iridex SLx, 3mm spot, 60 sec, 1000mW, Volk Superquad lens). Follow–up was at 3 and 6 months. At each of the 3 visits they had logMar BCVA, contrast acuity, OCT III, HRT II retina Module, color photography. Fluorescein angiography was undertaken at initial visit and at 6 months. Results: Follow–up data is available on nine patients. Preliminary analysis suggests a trend towards improved BCVA and reduced foveal thickness on OCTIII. Safety analysis has raised no issues and the study is ongoing. Conclusions: TTT may be of benefit in the management of patients with subfoveal diabetic macula edema. It may provide an alternative or adjunct to conventional laser therapy for diabetic subfoveal maculopathy. Further research is planned to determine the role of TTT in the management of diabetic macula edema.

Keywords: diabetes • macula/fovea • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled