Abstract:AIM: To determine the long-term efficacy of transpupillary thermotherapy (TTT) in the treatment of subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (AMD). METHODS: Fourteen eyes of 14 patients with subfoveal CNV secondary to AMD were treated with diode laser (810nm) TTT. The mean age was 67.1 years. Complete ophthalmic examination was done, color fundus photographs and macular optical coherence tomography scans were taken, fluorescein and indocyanine green angiography were performed during initial and at subsequent follow-up examinations. Treatment was given in one minute using 2-3mm spot sizes, and laser power settings were between 650-800mW. The follow-up period was between 5 and 64 months and the mean was 28.6 months. RESULTS: There was subfoveal classic CNV in 10, predominantly classic CNV in 2, minimally classic CNV in 1, and type 1 occult CNV in one of the fourteen eyes. Four patients were noted to have post-treatment hemorrhage which was absorbed in a short time. Macular non-perfusion occurred in one patient immediately after treatment. Most of the eyes demonstrated a decrease in exudation during the follow-up. With a mean follow-up of 28.6 months, visual acuity improved in 5, remained the same in 8 and decreased in 1 of the 14 eyes. CONCLUSION: Transpupillary thermotherapy is shown to close subfoveal CNV with rapid resolution of subretinal fluid while maintaining visual function in patients with AMD. It may be performed as an alternative laser treatment in classic and predominantly classic subfoveal choroidal neovascularization due to AMD.
