Intra–operative Enlargement of Haemorrhage during Transpupillary Thermotherapy for Choroidal Neovascular Membrane in Age Related Macular Degeneration.

Abstract

Abstract: : Purpose: To report a previously undescribed complication of Transpupillary thermotherapy (TTT) for the treatment of sub–foveal, choroidal neovascular membrane (CNV) secondary to age–related macular degeneration. Methods: TTT was delivered by an infrared diode laser of 810nm wavelength with the following parameters; power from 430 to 1070mW, duration of 60 seconds and spot size of 1.2, 2.0 and 3.0mm depending on the area of CNV. Results: Forty–one eyes (41 patients) received a total of 71 sessions of treatment. Three eyes (one predominantly classic CNV and two minimally classic CNV) developed a sub–retinal haemorrhage during the application of TTT. All patients had evidence of pre–existing haemorrhage, less than a quarter of the baseline lesion, which enlarged significantly and resulted in an immediate reduction in visual acuity of approximately 2 log–MAR lines. Despite resolution of sub–retinal haemorrhage, the visual acuity only partly recovered over the following six months. Conclusions: Intra–operative enlargement of sub–foveal haemorrhage was an unexpected complication of TTT in our population sample. This was associated with further irreversible reduction of visual acuity. Adjustment of treatment parameters may be considered in selected cases.

Keywords: choroid: neovascularization • clinical (human) or epidemiologic studies: outcomes/complications