May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Multimodality Transpupillary Thermotherapy and Radiotherapy of Occult Subfoveal Choroidal Neovascular Membranes in Age–Related Macular Degeneration
Author Affiliations & Notes
  • M.S. Ying
    Ophthalmology,
    Medical College of Georgia, Augusta, GA
  • J.J. Fuller
    Ophthalmology,
    Medical College of Georgia, Augusta, GA
  • J. Alexander
    Scheie Photographic Reading Center, University of Pennsylvania, Philadelphia, PA
  • W.C. Sheils
    Radiology,
    Medical College of Georgia, Augusta, GA
  • Y. Lee
    Ophthalmology, University of Texas – Southwestern, Dallas, TX
  • D.M. Marcus
    Ophthalmology,
    Medical College of Georgia, Augusta, GA
  • Footnotes
    Commercial Relationships  M.S. Ying, None; J.J. Fuller, None; J. Alexander, None; W.C. Sheils, None; Y. Lee, None; D.M. Marcus, None.
  • Footnotes
    Support  Support in part by Research to Prevent Blindness & Knights Templar of Georgia Educational Foundation
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 5136. doi:
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      M.S. Ying, J.J. Fuller, J. Alexander, W.C. Sheils, Y. Lee, D.M. Marcus; Multimodality Transpupillary Thermotherapy and Radiotherapy of Occult Subfoveal Choroidal Neovascular Membranes in Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5136.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose:To determine the safety and efficacy of combined transpupillary thermotherapy (TTT) and external beam radiation (EBR) for occult subfoveal choroidal neovascular membranes (CNV) in age–related macular degeneration (AMD). Methods: Eight patients with AMD–related occult subfoveal CNV and vision 20/400 or better were prospectively enrolled in a Phase I safety study. Delivery of one or more spots of TTT to cover the CNV lesion was applied with a diode laser (810 nm, spot size–3.0 mm, 60 sec., power–600–800mW). EBR was initiated within five hours after TTT and was delivered in 5 daily fractions of 4 Gy (20 Gy total dose). ETDRS–BCVA, fluorescein angiography and fundus photography were performed at baseline and prospectively determined follow–up periods. Photographic and angiographic data (type and size of CNV and degree of fibrosis/hemorrhage) were graded by the Scheie Photographic Reading Center. Results: 

No CNV lesion contained significant fibrosis or hemorrhage. Three patients (37%) had visual improvement of 2 or more lines with one gaining 6 lines. One patient (13%) maintained the same visual acuity, and the remaining four patients (50%) displayed visual decline of 2 or more lines with one losing 8 lines. One patient had severe visual loss immediate after TTT. Factors possibly correlating to poorer outcomes included: large–sized CNV, need for multiple TTT spots, and a history of previous thermal laser treatments. Conclusions:Combined TTT and EBR provided mixed results in treatment of AMD–related occult CNV. There were no obvious adverse safety concerns related to combination therapy.

Keywords: age–related macular degeneration • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • radiation therapy 
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