Transpupillary thermotherapy (TTT) for the treatment of choroidal neovascularisation

• Published in: British journal of ophthalmology Vol. 85; no. 2; pp. 173 - 178
• Main Authors: Newsom, R S B, McAlister, J C, Saeed, M, McHugh, J D A
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01-02-2001; BMJ; BMJ Publishing Group LTD
• Subjects: age related macular degeneration; Aged; Aged, 80 and over; Biological and medical sciences; choroidal neovascularisation; Choroidal Neovascularization - etiology; Choroidal Neovascularization - therapy; diode laser; Female; Fluorescein Angiography; Follow-Up Studies; Humans; Hyperthermia, Induced - methods; Laser Therapy; Lasers; Macular degeneration; Macular Degeneration - complications; Male; Medical imaging; Medical sciences; Melanoma; Membranes; Middle Aged; Occult sciences; Ophthalmology; Original articles - Clinical science; Patients; Photodynamic therapy; Pilot Projects; Retrospective Studies; transpupillary thermotherapy; Treatment Outcome; Uvea diseases; Visual Acuity; Human; Pupil; Eye disease; Treatment; Choroid; Uvea disease; Neovascularization; Thermotherapy
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.85.2.173

AIM To assess the effectiveness of transpupillary thermotherapy (TTT) for the treatment of classic and occult choroidal neovascularisation (CNV). METHOD In a retrospective, case selected, open label trial 44 eyes of 42 patients with CNV secondary to age related macular degeneration (ARMD) were studied. 44 eyes with angiographically defined CNV were treated with diode laser (810 nm) TTT. Laser beam sizes ranged between 0.8 and 3.0 mm and power settings between 250–750 mW. Treatment was given in one area for 1 minute, the end point being no visible change, or a slight greying of the retina. Outcome was assessed with Snellen visual acuity and clinical examination; in 24/44 patients angiographic follow up was available. RESULTS 12 predominantly classic CNV and 32 predominantly occult membranes were followed up for a mean of 6.1 months (range 2–19). Mean change in vision for classic membranes was −0.75 (SD 1.75) Snellen lines and occult membranes was −0.66 Snellen lines (2.1) (p>0.05). Predominantly classic membranes were closed in 75% (95% CI: 62.5–87.5) of eyes, remained persistent in 25% (95% CI: 12.5–37.5); no recurrences occurred. Predominantly occult membranes were closed in 78% (95% CI: 70.1–85.3) of eyes, remained persistent in 12.5% (95% CI: 6.6–18.5), and were recurrent in 5.1% (95% CI: 4.2–14.3). CONCLUSIONS Transpupillary thermotherapy is a potential treatment for CNV. It is able to close choroidal neovascularisation while maintaining visual function in patients with classic and occult disease. Further trials of TTT are needed to compare this intervention with the natural history and other treatment modalities.