Transpupillary Thermotherapy of Juxtafoveal Recurrent Choroidal Neovascularization

Purpose To evaluate the effectiveness of low power transpupillary thermotherapy (TTT) in treating juxtafoveal recurrent choroidal neovascularization (CNV) after laser photocoagulation in patients with age-related macular degeneration (ARMD). Methods Eight eyes of eight patients with ARMD and juxtafoveal recurrent CNV were treated with low power TTT, delivered using an 810-nm diode laser with 350 mW, 2.0 mm spot, and 1-minute duration. Visual acuity (VA) ranged from 20/100 to 20/50. Treatment effect was evaluated by fluorescein angiography, indocyanine green angiography, and VA measurements (Early Treatment Diabetic Retinopathy Study) at 1-week, 2-week, and monthly follow-up visits. Results NO retinal damage was visible ophthalmoscopically during treatment. At the first follow-up visit, seven eyes had obliteration of CNV and one eye required a second TTT application. VA was unchanged in six eyes, improved in one eye, and worsened in one eye. Recurrences occurred in all eyes between 1 and 7 months after TTT and were treated with photodynamic therapy (PDT). More than two PDT treatments were performed in each eye in the year after recurrence. Conclusions LOW power TTT is as able to close juxtafoveal recurrent CNV as is high power conventional laser photocoagulation but does not prevent recurrences. Further intervention with TTT in order to treat recurrences is under investigation.