Article Text

Transpupillary thermotherapy (TTT) for the treatment of choroidal neovascularisation
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  1. R S B Newsom,
  2. J C McAlister,
  3. M Saeed,
  4. J D A McHugh
  1. King's College Hospital, Denmark Hill, London SE5 9RS, UK
  1. Mr R S B Newsom, Department of Vitreoretinal Surgery, Moorfields Eye Hospital, City Road, London EC1V 2PD, UKrbnewsom{at}dircon.co.uk

Abstract

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.

  • age related macular degeneration
  • choroidal neovascularisation
  • transpupillary thermotherapy
  • diode laser

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Supplementary materials

  • CORRECTION

    In the paper published in the February issue of the BJO (2001;85:173–8) by Newsom et al, there was an error in Figure 4 (p 176). The axes are wrongly labelled. The y axis should read Post-TTT VA and the x axis should be Pre-TTT VA. We apologise for the error.

Footnotes

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