Transpupillary Thermotherapy of Occult Choroidal Neovascularization: One-Year Results

Abstract

Abstract: : Purpose: To assess the efficacy of transpupillary thermotherapy (TTT) for the treatment of occult choroidal neovascularization (CNV). Methods: A retrospective, non randomized, study of 66 eyes of 66 patients with occult CNV in age-related macular degeneration (AMD). Occult CNV were defined with fluorescein and indocyanine green angiography prior to treatment and at one year. Initial ETDRS visual acuity ranged from 20/200 to 20/40. TTT was applied with a 810nm-diode laser (BVI, Quantel). Laser beam size ranged from 2500 to 4000 µ m and power settings between 450 to 800mW. Treatment was given for 1 minute. No visible color change of the retina was seen at the end of the treatment. Two independent physicians evaluated the results through visual acuity, fundus and angiography examination. A visual acuity change of 3 lines (15 letters) in the ETDRS chart was considered clinically significant. Results: 9 patients were excluded because they were out of the inclusion criteria. Among the remaining 57 patients, visual acuity remained unchanged only in 10%, when 22 patients presented severe complications, as atrophic retinal scar (3) or occurrence of classic new vessels (19). Conclusions: As we have disappointing results, we have stopped treating occult CNV with TTT. However, this technique could be reconsidered if we can adjust the parameters of the laser in accordance with retina pigmentation and lens opacities.

Keywords: age-related macular degeneration • neovascularization • laser