Abstract
Abstract: :
Purpose: to assess the effectiveness of transpupillary thermotherapy (TTT) for the treatment of classic and occult choroidal neovascularisation (CNV). Methods: A retrospective, case selective, trial of 38 patients with angiographically defined CNV secondary to age–related macular degeneration (ARMD) treated with diode laser (810nm) TTT. Laser power ranged from 181–1490 mW and laser spot size ranged from 0.5–3mm. Treatment was given for 60 seconds. Outcome was assessed at 6 weeks with Snellen Visual Acuity and fundus flourescein angiogram (FFA). and at 3 months with Snellen Visual Acuity. Results: 4 eyes were subfoveal classic, 23 were subfoveal occult and 11 were mixed subfoveal classic and occult. At 6/52 post treatment the vision improved in 3/38 (7.9%) patients, stabilised (+/– 1 line) in 22/38 (57.9%) patients, was mildy reduced (2–5 lines) in 7/38 (18.4%) patients and severely reduced (>5 lines) in 6/38 (15.8%) patients. Final recorded best visual acuity showed improvement in 3/38 (7.9%) patients, stabilisation 18/38 (47.4%), mild loss 6/38 (15.8%) and severe loss 11/38 (28.9%). In all eyes the mean size of the CNV was 6.82mm2 but ranged from 0.1–26.84mm2. At six weeks post treatment the area of CNV was smaller on FFA in 10/30 (26.3%) and was larger in 10 (26.3%) patients, post treatment FFA results were not repeated on 18 patients, 11 of these patients (26.3%) were left with an atrophic or disciform scar clinically. There were no significant differences between classic and occult membranes. Conclusions: TTT is a treatment for CNV. There is stabilisation or improvement of vision in 21/38 (55.3 %) of patients. Further randomised controlled trials are required.