Abstract
Purpose
To evaluate the therapeutic outcome and the recurrence of choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) after transpupillary thermotherapy (TTT) in light-brown retinas.
Methods
A retrospective, non-randomized study of 58 eyes in 55 patients with subfoveal CNV treated with TTT was conducted. Power settings were set about half the value for Caucasian eyes. The outcome was assessed with best-corrected visual acuity, fluorescein angiography, indocyanine green angiography, and fundoscopic examination.
Results
Forty-four membranes were occult, six classic, and eight mixed. Mean follow-up was 16.6±10.7 months (range: 6–48 months). Membranes closed in 46 eyes. Iatrogenic complications included three subretinal haemorrhage, two retinal pigment epithelium tears, and two macular area cystic changes. In eyes with occult CNV, visual acuity improved in six (13.6%), 14 (31.8%) remained unchanged, and 24 (54.6%) deteriorated. For various CNV, average logMAR changes from baseline at last follow-up were 0.30 in occult, −0.08 in classic, and 0.59 in mixed (P<0.01). Thirty eyes experienced recurrence within 9.2±6.2 months (range: 2–22 months). Cumulative recurrence rate was 45% at 12 months and 71% at 22 months, with no significant difference between occult and non-occult type CNV.
Conclusions
Transpupillary thermotherapy does not cure CNV secondary to AMD. High recurrence was found independent of CNV type. Most improved vision was found mostly in classic CNV. Complications associated with high energy level should be considered in light-brown retinas.
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References
Klein R, Klein BE, Linton KL . Prevalence of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology 1992; 99: 933–943.
Leibowitz HM, Krueger DE, Maunder LR, Milton RC, Kini MM, Kahn HA et al. The Framingham Eye Study monograph: an ophthalmological and epidemiological study of cataract, glaucoma, diabetic retinopathy, macular degeneration, and visual acuity in a general population of 2631 adults, 1973–1975. Surv Ophthalmol 1980; 24: 335–610.
Macular Photocoagulation Study Group. Laser photocoagulation of subfoveal neovascular lesions of age-related macular degeneration: updated findings from two clinical trials. Arch Ophthalmol 1993; 111: 1200–1209.
Macular Photocoagulation Study Group. Visual outcome after laser photocoagulation for subfoveal choroidal neovascularization secondary to age-related macular degeneration. The influence of initial lesion size and initial visual acuity. Arch Ophthalmol 1994; 112: 480–488.
Freund KB, Yannuzi LA, Sorenson JA . Age-related macular degeneration and choroidal neovascularization. Am J Ophthalmol 1993; 115: 786–791.
Bressler NM, Arnold J, Benchaboune M, Blumenkranz MS, Fish GE, Gragoudas ES et al. Verteporfin therapy of subfoveal choroidal neovascularization in patients with age-related macular degeneration: additional information regarding baseline lesion composition's impact on vision outcomes—TAP report No. 3. Arch Ophthalmol 2002; 120: 1443–1454.
Bressler NM, Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) Study Group. Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with vertiporfin: two year results of 2 randomized clinical trials—TAP report 2. Arch Ophthalmol 2001; 119: 198–207.
Reichel E, Berrocal AM, Ip M, Kroll AJ, Desai V, Duker JS et al. Transpupillary thermotherapy of occult subfoveal choroidal neovascularization in patients with age-related macular degeneration. Ophthalmology 1999; 106: 1908–1914.
Mainster MA, Reichel E . Transpupillary thermotherapy for age-related macular degeneration: long-pulse photocoagulation, apoptosis, and heat shock proteins. Ophthalmic Surg Lasers 2000; 31: 359–373.
Newsom RS, McAlister JC, Saeed M, McHugh JD . Transpupillary thermotherapy (TTT) for the treatment of choroidal neovascularization. Br J Ophthalmol 2001; 85: 173–178.
Thach AB, Sipperley JO, Dugel PU, Sneed SR, Park DW, Cornelius J et al. Large-spot size transpupillary thermotherapy for the treatment of occult choroidal neovascularization associated with age-related macular degeneration. Arch Ophthalmol 2003; 121: 817–820.
Atarashi T, Tamaki Y, Inoue Y, Obata R, Muranaka K, Yanagi Y et al. Transpupillary thermotherapy for treatment of exudative age-related macular degeneration in Japanese patients. Eye 2004; 18: 615–618.
Treatment of Age-related Macular Degeneration with Photodynamic Therapy (TAP) Study Group. Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials—TAP report. Arch Ophthalmol 1999; 117: 1329–1345.
Verteporfin in Photodynamic Therapy Study Group. Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration: two-year results of a randomized clinical trial including lesions with occult with no classic choroidal neovascularization-verteporfin in photodynamic therapy report 2. Am J Ophthalmol 2001; 131: 541–560.
Rougier MB, Francois L, Fourmaux E, Isber R, Colin J, Korobelnik JF . Complications and lack of benefit after transpupillary thermotherapy for occult choroidal neovascularization: 1-year results. Retina 2005; 25: 784–788.
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Tsai, TH., Yang, CM., Yang, CH. et al. Transpupillary thermotherapy for the treatment of choroidal neovascularization in age-related macular degeneration in Taiwan. Eye 21, 721–726 (2007). https://doi.org/10.1038/sj.eye.6702312
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DOI: https://doi.org/10.1038/sj.eye.6702312
