Transpupillary Thermotherapy in Age-Related Macular Degeneration

Overview

Objective.
To evaluate anatomical and functional results of transpupillary thermotherapy(TTT) in age-related macular degeneration (ARMD) with a chorioidneovascular membrane (CNVM).Material and methods. TTT was performed by means of a diode laser (Iris MedicalOculight Six) in 38 eyes of 35 patients aged 46-93 years, mean 70.6 years. OcultCNVM was treated in 34 eyes, classical CNVM in 4 eyes. In TTT we applied 1 to 5points (on average 1.9 spot) and used a laser beam with a diameter of 0.5-3 mm(mean width 1.61 mm). In 10 eyes with occult CNVM (29%) TTT was repeated after1-6 months. The patients were followed up after TTT for 6-18months on averagefor 9.5 months.Results. The final visual acuity (VA) improved after TTT in two eyes (5.3 %),remained unchanged in 22 eyes (57.9 %) and deteriorated in 14 eyes (36.8 %). Themean VA after TTT declined from 0.23 to 0.17.Biomicroscopic manifestations of exudation disappeared or receeded in 29 eyeswith occult CNVM (85.3 %) and in 3 eyes with classical CNVM (75%). Fluoroangiographic examination revealed a reduced or absent extravasation of the dye in 24eyes with occult CNVM (70.5 %) and in 3 eyes with classical CNVM (75%). Opticcoherent tomography confirmed regression of exsudative changes and the developmentof a chorioretinal scar in 23 eyes with occult CNVM (67.6 %) and 3 eyeswith classical CNVM (75 %).Conclusion. TTT is a new potential therapy of ACMD with CNVM. It is indicatedin particular in occult CNVM. It can be however used also in classical CNVM. TTTis not economically pretentious and can be used also in other than large clinicaldepartments. It is important to test the possibilities and limitations of TTT ona large number of patients and assess its position among other therapeuticprocedures.

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