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MF White, JO Mason, RM Feist, G McGwin, TL Emond; Transpupillary Thermotherapy Of Occult Choroidal Neovascularization: 18 Month Follow-up . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4415.
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Purpose: To assess the long term efficacy and safety of transpupillary thermotherapy (TTT) for the treatment of greater than 50% occult subfoveal choroidal neovascularization (CNV) in patients with age-related macular degeneration (AMD). Methods: We retrospectively reviewed the charts of 39 consecutive patients (39 eyes) who underwent TTT for greater than 50% occult CNV secondary to AMD between December 1999 and February 2000. TTT was delivered using an 810mm diode laser and one subfoveal spot for 60 seconds with a spot size of 2mm or 3mm and a power setting of 400mW to 800mW as a subthreshold treatment, i.e., we did not treat to a visual endpoint. All patients had a post-laser follow-up of 18 months or greater. Visual acuity, subfoveal exudation, laser spot size, laser power and retreatment were analyzed using Fischer's Exact test. Results: With 18 months follow-up, 26 of 39 patients (67%) had stable or improved (no change or equal to or greater than one line) visual acuity. Thirty-three of 36 patients (92%) exhibited stable or decreased subfoveal exudation. Thirteen patients (33%) underwent retreatment secondary to worsening exudation within three months of the intitial treatment. Using the Fischer's Exact test, there is no significant statistical correlation between those receiving retreatment and those having one treatment with regards to visual acuity at the 18-month follow-up visit. Laser spot size and laser power setting did not appear to influence the visual outcome using Fischer's Exact test. Conclusion: TTT shows no deleterious side effects over 18 month follow-up and may decrease subfoveal exudation and stabilize visual acuity in patients with greater than 50% occult subfoveal CNV. Retreatment does not appear to reduce the chances of good visual outcome.
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