Purchase this article with an account.
SH Kim, JE Kim, TB Connor, WJ Wirostko, DP Han; Transpupillary Thermotherapy for the Treatment of Occult Subfoveal Choroidal Neovascularization in Age Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4418.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the efficacy of transpupillary thermotherapy (TTT) for the treatment of occult subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (ARMD). Methods: 58 eyes in 55 patients (age 59 - 96) with at least 6 months of follow-up were included. A complete ophthalmologic examination, fundus color photographs and a fluorescein angiogram (FA) were obtained on each patient. TTT was delivered using an infrared diode laser at 810 nm with a spot size of 2.0 mm and power of 530 mW or 3.0 mm and 800 mW. A single or multiple spots were used in a single session to encompass the entire CNV. The main outcome measures were proportion of eyes with less than 3 lines of Snellen visual acuity loss, number of retreatments and final exudative response based on clinical examination and FA. Results: Pre-treatment visual acuity ranged from 20/40 - 20/400. The follow-up period consisted of 6 - 16 months (mean = 9 months). 17 of 58 eyes had a retinal pigment epithelial detachment on pre-treatment FA. 10 of 58 eyes received multiple spot treatment for large CNV. 42 of 58 (72%) eyes lost fewer than 3 lines of Snellen visual acuity. Of the eyes treated with a single laser spot, 34 of 48 (71%) eyes lost fewer than 3 lines of visual acuity, while 8 of 10 (80%) eyes treated with multiple laser spots lost fewer than 3 lines of visual acuity. 5 of 58 (8.6%) eyes lost greater than 6 lines of vision. In 4 of 58 eyes, the initial occult CNV became predominantly classic after TTT and subsequently underwent photodynamic therapy (3) or macular translocation (1). 5 of 58 eyes developed submacular hemorrhage during follow-up period. Number of treatment sessions ranged between 1 and 3. 11 of 58 (19%) eyes received more than one treatment. In the final examination, there was no active CNV exudation in 46 of 58 (79%) eyes. Conclusion: TTT appears to be a safe treatment for preserving vision and reducing exudation in eyes with occult subfoveal CNV in ARMD. Larger CNV may also be eligible for treatment using multiple laser spots in a single TTT session.
This PDF is available to Subscribers Only