经瞳孔温热疗法治疗渗出型老年性黄斑变性的临床疗效观察

目的
评价经瞳孔温热疗法(transpupillary thermotherapy,TTT)治疗渗出型老年性黄斑变性（age-related macular degeneration, AMD）的临床疗效。
方法
回顾分析62例确诊为AMD的患者的62只患眼TTT治疗的临床资料。62例AMD患眼中，行荧光素眼底血管造影(fundus fluorescein angiography，FFA)检查者58例，吲哚青绿血管造影(indocyanine green angiography ,ICGA)检查者42例，光相干断层成像术(optic coherence tomography, OCT)检查者56例。激光治疗机波长为810 nm，光斑0.5～3.0 mm,能量60～400 mW,照射时间60 s。62例患者治疗后随访观察1～10个月，平均随访观察时间4.8个月，分析末次随访视力与治疗前视力以及OCT复查资料。
结果
视力不变者43例，占69.4%；进步者15例，占24.2%；下降者4例，占6.5%。51例OCT复查者中，黄斑水肿不变者29例，占56.96%；好转者18例，占38.3%；恶化者4例，占7.8%。视力改善与OCT黄斑水肿的形态改善相一致者38只眼，占OCT检查者的74.5%；视力改善滞后于黄斑水肿形态改善者13只眼，占25.5%。再次行TTT治疗者18只眼，占接受TTT治疗者的29.0%。治疗随访期间无明显治疗副作用。
结论
TTT治疗能使大部分渗出性AMD患眼视力稳定或提高，使用安全，但激光治疗参数尚需进一步探索。
(中华眼底病杂志, 2002, 18: 180-183)     

光学相干断层扫描在经瞳孔温热疗法治疗老年性黄斑变性中的应用

目的　探讨光学相干断层扫描 (OCT)对经瞳孔温热疗法 (TTT)治疗渗出型老年性黄斑变性 (AMD )的临床应用价值。方法　对渗出型AMD3 5例 ( 3 6眼 )进行光学相干断层扫描(OCT)、荧光素眼底血管造影 (FFA)、吲哚青绿脉络膜血管造影 (ICGA )检查。根据FFA、ICGA和OCT检查结果 ,明确CNV位置、范围和大小 ,采用半导体红外激光 ( 810nm)进行TTT治疗 ,并对其疗效进行评价。结果　TTT治疗后视力提高者 10眼 ,占 2 7 8% ;视力稳定不变者 17眼 ,占47 2 % ;视力下降者 9眼 ,占 2 5 %。OCT复查结果为 11眼 ( 3 0 6% )黄斑水肿消失 ;14眼( 3 8 9% )黄斑水肿减轻 ;8眼 ( 2 2 2 % )无变化 ;3眼 ( 8 3 % )黄斑水肿加重。CNV消失 12眼( 3 3 3 % ) ,CNV缩小 19眼 ( 5 2 8% ) ,CNV无变化 3眼 ( 8 3 % ) ,CNV增大 2眼 ( 5 6% ) ;治疗后视网膜厚度明显变薄 (P <0 0 0 1)。黄斑中心凹视网膜神经上皮层厚度与视力呈负相关 (r =0 4963 ,P =0 0 0 1)。结论　OCT可客观、精确地显示CNV的位置、大小范围及视网膜水肿的变化程度 ,对指导TTT治疗AMD和疗效评价有着重要价值。     

光动力疗法治疗渗出型老年性黄斑变性四年临床观察总结

目的 总结4年来光动力疗法（PDT）治疗渗出型老年性黄斑变性(AMD)的临床疗效，以评价PDT的长期治疗效果。 方法 回顾73例经双目间接检眼镜、荧光素眼底血管造影(FFA)、吲哚青绿血管造影(ICGA)检查确诊的渗出型AMD患者的95只患眼行PDT治疗前后的临床资料，对比分析其视力、眼底像、FFA、ICGA和光相干断层扫描(OCT)检查结果的变化。73例患者平均年龄67.8岁，就诊时最佳矫正视力数指/10 cm～1.0。95只眼PDT平均治疗次数为1.5次，治疗后随访时间为3个月～4年。 结果 PDT治疗后末次随访时，39只眼视力提高≥2行，占41.1％；51只眼视力波动在1行以内，占53.7％；5只眼视力下降≥2行，占5.3％ 。所有患眼眼底出血和渗出均减轻。FFA或FFA联合ICGA检查显示：58只眼脉络膜新生血管（CNV）渗漏完全停止，转为瘢痕期，占61.05％；6只眼CNV部分闭合， 占6.32％；22只眼CNV小部分闭合，占23.16％；9只眼CNV复发，占9.47％。早期AMD患者12只眼经过1次PDT治疗后，最佳矫正视力0.6～1.5，CNV完全闭合，OCT检查显示黄斑区水肿及神经上皮脱离消失。随访时间最长达4年，未见有复发，视力保持稳定。 结论 单次和重复PDT治疗渗出型AMD长期疗效较好，安全性较高。对于早期渗出型AMD患者微小典型性CNV，单次PDT治疗可以使其完全封闭，使患者视力保持在较好的水平。 （中华眼底病杂志，2004，20：275-279）     

渗出型老年黄斑变性的吲哚菁绿血管造影图像特征

目的 探讨渗出型老年黄斑变性(AMD)吲哚菁绿血管造影(ICGA)与荧光素眼底血管造影(FFA)比较的图像特征。方法 对52例65眼渗出型AMD患者进行了眼底彩色照相、FFA和ICGA检查。结果 渗出型AMD的65眼中，ICGA诊断为典型性脉络膜新生血管(CNV)有33跟．占50．8％，FFA诊惭为典型性CNV有8眼，占11．6％；FFA诊断为隐匿性CNV的35眼中，ICGA诊断为边界清楚或久清楚的斑状CNV有22眼；合并黄斑出血39眼中，FFA不能发现的CNV而ICGA能发现共5眼；FFA诊断为痕痕染色的7眼中，有2眼有ICGA中发现CNV；ICGA发现CNV的供养血管(feeding vessel)有3眼。结论 ICGA比FFA发现CNV诊断率高，准确地显示黄斑出血所掩盖的CNV，ICCA有助丁发现CNV的供养血管。     

经瞳孔温热疗法治疗老年性黄斑变性的疗效观察

目的 观察经瞳孔温热疗法(transpupillary thermotherapy,TTT)治疗渗出型老年性黄斑变性(age—related macular degeneration，AMD)隐匿型脉络膜新生血管(choroidal neovascularization，CNV)的效果。方法 对28例34眼经眼底荧光血管造影(fundus fluorescein angiography，FFA)及吲哚青绿血管造影(indocyanine green angiography，ICGA)确诊的继发于渗出型AMD的隐匿型CNV行TTT治疗，并主要以视力、眼底检查、FFA及ICGA改变为指标，评价TTT治疗渗出型AMD的效果。结果 随访3～20个月，平均6.65个月，视力提高19眼，视力稳定13眼，视力下降2眼，视网膜水肿基本消退6眼，水肿明显减轻21眼，水肿无明显变化5眼，2眼水肿加重，出血吸收22眼，8眼出血减少，出血无明显变化者2例，另有2眼发生少量新鲜视网膜深层出血，第1次治疗后复查FFA及ICGA，10眼CNV消失，19眼CNV渗漏减轻，3眼无明显变化，2眼CNV增大。结论 TTT治疗可使大部分AMD患者视力稳定或提高，是一种极具潜力的治疗方式，但对其确切疗效的评价。尚需与自然病程及其他治疗方法对比。     

吲哚青绿脉络膜血管造影对激光光凝治疗年龄相关性黄斑变性应用价值

目的：探讨吲哚青绿脉络膜血管造影对指导激光光凝治疗年龄相关性黄斑变性(AMD)的应用价值。方法：采用激光扫描检眼镜(SLO)对55例(60眼)渗出型AMD进行眼底荧光血管造影术(FFA)和吲哚青绿脉络膜血管造影术(ICGA)检测，对比分析FFA和ICGA图像，发现黄斑区视网膜下脉络膜新生血管(CNV)的位置、范围、大小和数目，观察CNV的供养血管(FV)。在FFA和ICGA图像的指导下，对不同类型CNV分别半导体近红外激光(810nm)和Fd—Nd：YAG激光(532nm)波长激光进行光凝治疗。治疗后根据病人视力、眼底变化、FFA和ICGA复查结果综合评价疗效。结果：60眼渗出型从AMD中，FFA发现典型CNV24眼，占40％，隐匿性CNV36眼，占60％；ICGA检查60眼中，典型CNV45眼，占75％；典型CNC伴有明显供养血管(FV)18眼；显示CNV的热点10眼，占16．7％；盘状高荧光5眼，8．3％。IC—GA典型CNV发现率明显高于FFA，P＜0．001。激光光凝治疗渗出AMD60眼中，显效21眼，占35．0％；有效16眼，占26．7％；无效23眼，占38．3％；复发12眼，占20．0％。疗效明显高于对照组，P＜0．01。结论：ICGA可提高隐匿型CNV发现率，在ICGA指导下，采用不同波长激光治疗可取得更好效果，并可客观评价疗效。     

经瞳孔温热疗法治疗中心性渗出性脉络膜视网膜炎的疗效观察

目的 探讨经瞳孔温热疗法(traspupillary thermotherapy, TTT)治疗中心性渗出性脉络膜视网膜炎(central exudative chorioretinopathy,CEC)的临床效果。 方法 对荧光素眼底血管造影(fundus fluorescein angiography,FFA)和吲哚青绿血管造影(indocyanine green angiography,ICGA)检查确诊的CEC患者的12只患眼进行TTT治疗。采用810 nm半导体激光，光斑0.5～2.0 mm，照射时间55～60 s，能量200～350 mW，对 FFA和ICGA图像所显示的脉络膜新生血管(choroidal neovascularization,CNV)进行照射，照射区未出现颜色变化或呈淡灰色。对比分析患者治疗前后的视力、眼底、FFA和ICGA检查结果。 结果 TTT治疗后0.5～3个月后所有患眼视力都有不同程度提高，视力提高5行以上者4只眼，占33.3%；3～5行者 5只眼，占41.7%；1～2行者 3只眼，占25.0%。治疗后10只眼行FFA和ICGA复查，其中FFA复查荧光素渗漏消失7只眼，减轻3只眼；ICGA复查CNV消失或明显缩小8只眼，CNV无变化2只眼。 结论 TTT治疗CEC效果良好，值得临床推广应用。 (中华眼底病杂志, 2002, 18: 187-189)     

光动力疗法治疗老年性黄斑变性合并脉络膜新生血管的临床观察

目的 观察单次光动力疗法(photodynamic therapy, PDT)治疗渗出型老年性黄斑变性(age-related macular degeneration, AMD)合并脉络膜新生血管(choroidal neovascularization, CNV)的短期治疗效果。 方法 回顾分析经荧光素眼底血管造影(fundus fluorescein angiography, FFA)、吲哚青绿血管造影(indocyanine green angiography,ICGA)和光相干断层成像术(optic coherence tomography, OCT)等检查确诊的30例渗出型AMD患者的35只患眼行PDT治疗前和治疗后1周,1、3个月的临床资料，以视力、FFA、ICGA和OCT检查结果为观察指标，评价PDT对渗出型AMD的短期治疗效果。 结果 治疗后3 个月内有34只眼视力不变或提高，1只眼因出血而视力下降；FFA检查显示有19只眼荧光素渗漏减轻或完全消退；OCT检查显示视网膜水肿和浆液性脱离明显好转。全部患者治疗过程中未发生任何不良反应；治疗后3例患者主诉有一过性视物变暗，2例主诉轻微背痛。 结论 PDT治疗渗出型AMD时，可短期封闭CNV，使渗漏减轻或消退，对视力无损害。 (中华眼底病杂志, 2002, 18: 171-174)     

光动力疗法治疗渗出性年龄相关性黄斑变性

目的观察光动力疗法(photodynamic therapy,PDT)治疗渗出性年龄相关性黄斑变性(age-related macular degeneration,AMD)的疗效。方法回顾分析经荧光素眼底血管造影(fundus fluorescein angiography,FFA)、吲哚菁绿血管造影(indocyanine green angiography,ICGA)以及光学相干断层扫描(optical coherence tomography,OCT)检查确诊的21例(31眼)渗出性AMD患者PDT治疗前及治疗后的临床资料,主要以视力、FFA及(或)ICGA、OCT的改变为观察指标,评价PDT对渗出性AMD的治疗效果。结果治疗后13眼视力明显改善(视力提高≥2行),占41.9%;14眼视力稳定不变(视力波动在1行以内),占45.2%;4眼视力下降2行,占12.9%。大部分患眼于PDT治疗后眼底出血和渗出减轻;ICGA检查显示:PDT治疗后1周,16眼CNV的渗漏明显减少或完全停止,8眼渗漏完全停止。OCT检查显示:CNV周围视网膜脉络膜水肿以及神经上皮脱离好转。5例6眼患者在PDT治疗过程中及治疗后发生视网膜神经上皮脱离范围变大,1例1眼发生黄斑部再次大面积出血,所有病例均未发生任何全身不良反应。结论单次和重复PDT治疗可以部分或完全封闭渗出性AMD的CNV,PDT治疗对病灶周围的正常视网膜和脉络膜组织短期内有轻度影响,对视力无损害。     

经瞳孔温热疗法治疗中心性渗出性脉络膜视网膜病变的初步观察

目的:探讨经瞳孔温热疗法(transpupillary thermotherapy,TTT)治疗中心性渗出性脉络膜视网膜病变(central exudative chorioretinopathy,CEC)的临床效果.方法:对眼底荧光素血管造影(fundus fluorescein angiography,FFA)和吲哚青绿血管造影(indo cyanine green angiography,ICGA)检查确诊的CEC患者的18只患眼进行TTT治疗.采用810nm半导体激光,光斑0.8～2.O mm,照射时间60s,能量80～300 mW,对FFA和ICGA图像所显示的脉络膜新生血管(choroidal neo vascularization,CNV)进行照射,照射区未出现颜色变化.对比分析患者治疗前后的视力、眼底、FFA结果.结果:治疗后视力提高者6眼,占33%;无变化者12眼,占67%.自觉症状有程度不同的改善者16眼,眼底检查病变减轻者10眼.13眼复查眼底血管造影,其中8眼脉络膜新生血管(choroidalneovascularization,CNV)明显消退、渗漏减轻.结论:TTT治疗CEC效果良好,值得临床推广应用.     

低能量TTT联合曲安奈德球后注射治疗中心性渗出性脉络膜视网膜病变

目的: 探讨低能量经瞳孔温热疗法(transpupillary thermotherapy,TTT)联合曲安奈德(triamcinolone acetonide,TA)球后注射治疗中心性渗出性脉络膜视网膜病变(central exudative chorioretinopathy,CEC)的临床效果及安全性。方法: 对14例14眼CEC患者首先球后注射TA40mg/1mL+20g/L利多卡因0.5mL,然后于注射后1wk时再使用810nm半导体激光进行低能量TTT治疗(激光参数分别为:光斑直径0.8～3.0mm,照射时间60s,能量120～360mW),采用矫正视力、直接检眼镜、荧光素眼底血管造影(fundus fluorescein angiography,FFA)及光相干断层扫描(optical coherence tomography,OCT)来观察治疗后的效果及不良反应,随访3～12mo。结果: 治疗后视力提高者5眼(36%),无变化者8眼(57%),视力下降者1眼(7%)。12眼在治疗2wk后黄斑区出血、渗出明显减少,其中5眼在1mo后完全吸收,7眼在3mo后完全吸收,2眼眼底出现明显的黄斑瘢痕形成。治疗后3mo时,FFA检查发现CNV渗漏明显消退、减轻者7眼,无明显变化者5眼,2眼CNV扩大或渗漏增强;OCT检查发现12眼黄斑水肿均有不同程度改善,CNV强反射区域减小或者稳定,另2眼黄斑水肿加重、CNV扩大。结论: 低能量TTT联合TA球后注射对CEC有较好的治疗效果,临床上值得应用。     

Transpupillary thermotherapy (TTT) for age-related macular degeneration

Purpose. To review the results of transpupillary thermotherapy (TTT) on choroidal neovascular membranes associated with age-related macular degeneration (AMD). Materials and Methods. 35 eyes of 35 patients with AMD and choroidal neovascularization and exudation were treated with TTT and had fundus photographs and fluorescein angiography (FA) before and at least six months after TTT. 28 eyes had predominantly occult lesions as seen on FA, while 7 demonstrated primarily classic lesions. All were treated with 650 mw power or less using the 810 nm diode laser (3000 micron spot, duration of 60 seconds). Visual acuity, lesion size, and amount of subretinal fluid were determined by results of examination and review of photographs and fluorescein angiograms. Results. A 50% reduction in subretinal fluid was achieved in 67% of treated eyes overall, with stabilization of vision (less than three lines of visual acuity lost) in 86%. Complications from treatment were infrequent (9%) and involved hemorrhage noted in the region of treatment upon follow-up. Conclusion. TTT promotes resolution of subretinal fluid and appears to stabilize visual acuity in patients with exudative AMD.     

Transpupillary thermotherapy (TTT) for age-related macular degeneration

PURPOSE: To review the results of transpupillary thermotherapy (TTT) on choroidal neovascular membranes associated with age-related macular degeneration (AMD). MATERIALS AND METHODS: 35 eyes of 35 patients with AMD and choroidal neovascularization and exudation were treated with TTT and had fundus photographs and fluorescein angiography (FA) before and at least six months after TTT. 28 eyes had predominantly occult lesions as seen on FA, while 7 demonstrated primarily classic lesions. All were treated with 650mw power or less using the 810 nm diode laser (3000 micron spot, duration of 60 seconds). Visual acuity, lesion size, and amount of subretinal fluid were determined by results of examination and review of photographs and fluorescein angiograms. RESULTS: A 50% reduction in subretinal fluid was achieved in 67% of treated eyes overall, with stabilization of vision (less than three lines of visual acuity lost) in 86%. Complications from treatment were infrequent (9%) and involved hemorrhage noted in the region of treatment upon follow-up. CONCLUSION: TTT promotes resolution of subretinal fluid and appears to stabilize visual acuity in patients with exudative AMD.     

经瞳孔温热疗法治疗中心性渗出性脉络膜视网膜炎

目的 观察经瞳孔温热疗法(transpupillary thermotherapy,TTT)对中心性渗出性脉络膜视网膜炎(central exudative chorioretinopathy,CEC)的治疗效果。 方法 使用Iris 810 nm 半导体激光对29例CEC患者进行TTT治疗，采用1.2、2.0及3.0 mm光斑，能量80～300 mW，照射时间60 s。随访4～40周，通过视力、直接检眼镜检查、荧光素眼底血管造影(fundus fluorescein angiography,FFA)及吲哚青绿血管造影(indocyanine green angiography,ICGA)观察治疗效果。 结果 治疗后视力提高者8例，占28%；无变化者19例，占65％；视力下降者2例，占7%。12例患者症状有程度不同的改善，眼底检查病变减轻者10例。20例复查眼底血管造影的患者中，12例脉络膜新生血管(choroidal neovascularization,CNV)明显消退、渗漏减轻。 结论 TTT对CEC有较好的治疗效果。 (中华眼底病杂志, 2002, 18: 184-186)     

经瞳孔温热疗法和光动力疗法治疗渗出型老年性黄斑变性短期疗效比较

目的 比较经瞳孔温热疗法(TTT) 和光动力疗法(PDT)治疗渗出型 老年性黄斑变性(AMD)脉络膜新生血管(CNV)的疗效。 方法 对比分析渗出性AMD患者行PDT 治疗的35例42只眼、TTT治疗的35例40只眼治疗前和治疗后3个月的临床资料。所有患者治疗前后均进行视力 、荧光素眼底血管造影（FFA）、吲哚青绿血管造影（ICGA）和光相干断层扫描（OCT）检查 。CNV类型均为黄斑中心凹下型或旁中心凹型。其中，隐匿性或隐匿性为主型的CNV44只眼 ，典型性及典型性为主型的CNV38只眼。PDT治疗的42只眼中，隐匿性或隐匿性为主型CNV19只眼，典型性或典型性为主型CNV23眼；TTT治疗的40只眼中，隐匿性或隐匿性为主型CNV25只眼，典型性及典型性为主型CNV15只眼。 结果 典型性或典型性为主型CNV治疗后1、3个月时，PDT组分别有47.8%、43.5%的患眼视力提高2行以上；TTT组分别有6.7%、6.7%的患眼视力提高2行以上。两组之间治疗后1、3个月时视力提高的比例比较，差异均有显著性的意义（χ2=7.118,P=0.0076；χ2=5.500,P=0.0190）。PDT组分别有100%、69.6%的患眼CNV荧光素渗漏停止或改善；TTT组分别有53.2%、80.0%的患眼CNV荧光素渗漏停止或改善。两组之间治疗后1个月时CNV荧光素渗漏停止或改善的比例比较，差异有显著性的意义（χ2=13.16,P=0.0003）；3个月时CNV荧光素渗漏停止或改善的比例比较，差异无显著性的意义（χ2=0.5098,P=0.4752）。隐匿性或隐匿性为主型CNV治疗后1、3个月时，PDT组分别有15.8% 、10.5%的患眼视力提高2行以上；TTT组分别有4.0%、8.0%的患眼视力提高2行以上。两组之间治疗后1、3个月时视力提高的比例比较，差异均无显著性的意义（χ2=1.816,P=0.17 78；χ2=0.0838,P=0.7728）。PDT组分别有78。9%、42.1% 的患眼CNV荧光素渗漏停止或改善；TTT组分别有52.0%、84.0%的患眼CNV荧光素渗漏停止或改善。两组之间治疗后1个月时CNV荧光素渗漏停止或改善的比例比较，差异无显著性的意义（2=3.388,P=0.0657）；3个月时CNV荧光素渗漏停止或改善的比例比较，差异具有显著性的意义（χ2=8.433,P=0.0037）。 结论 典型性及典型性为主型CNV治疗后3个月视力结果PDT优于TTT；治疗后1个月时FFA检查渗漏改善PDT明显优于TTT，但随诊至3个月时，二者疗效差异无显著性的意义。隐匿性或隐匿性为主型CNV治疗后3个月视力结果PDT与TTT差异无显著性的意义；治疗后1个月FFA检查渗漏改善改善PDT与TTT差异无显著性的意义，但随诊至3个月时，CNV渗漏消失和减少方面TTT疗效明显好于PDT。尚需要更多的病例及更长的随诊时间来评价两种治疗方法的疗效.（中华眼底病杂志，2004，20：285-288）     

Transpupillary thermotherapy of occult choroidal neovascularization in age-related macular degeneration

PURPOSE: To evaluate the efficacy of transpupillary thermotherapy (TTT) in management of occult subfoveal choroidal neovascularization (CNV) in exudative age-related macular degeneration (AMD). METHODS: Retrospective chart review of eyes that were treated with TTT and had at least 12 weeks of follow-up. Base-line and final ETDRS visual acuity and fluorescein angiography (FA) were compared. RESULTS: For the 48 eyes which met inclusion criteria, mean pre-operative visual acuity was 20/128 (range: 20/50-20/500). Average follow-up was 27 weeks (range: 12 weeks-55 weeks). At 3 months after treatment, 12 eyes (25%) improved 2 lines or more, 18 eyes (37.5%) had no change or 1 line of visual improvement, and 18 eyes (37.5%) worsened 1 or more lines. No significant adverse event was noted during treatment. Three eyes developed large submacular hemorrhage within 2 months of treatment. Based on clinical examination and FA, 61% of the eyes appeared to have reduction of subretinal fluid compared to pre-operative evaluations. CONCLUSION: Visual acuity was stable or improved in 62.5% of eyes in our series and the treatment was well tolerated. Longer follow up and larger number of patients would be required to evaluate the ultimate benefit of TTT in management of occult CNV due to AMD.     

Transpupillary thermotherapy in exudative age-related macular degeneration

PURPOSE: Assessment of TTT results in patients with exudative age-related macular degeneration. MATERIAL AND METHODS: The study comprised of 65 patients (73 eyes), in age 50-84 years (average age-75 yrs). The diagnosis of exudative AMD was established on the basis of fundus examination and fluorescein angiography (FA) and in some cases on indocyanine green angiography. The baseline visual acuity (VA) ranged from counting fingers at 50 cm to 0.8. In 31 (42.5%) eyes occult CNV, in 11 (15%) minimally classic CNV and in 31 (42.5%) eyes predominantly classic CNV were observed. Subfoveal CNV was present in 70 (95.9%) eyes and perifoveal in 3 (4.1%). TTT was delivered using a diode laser at 810 nm wavelength, a spot size of 1.2 to 4.5 mm and a duration of 60 seconds for each spot with power settings between 320-800 mW. Follow-up examinations were carried out every 10-12 weeks. In cases with persistent leakage from CNV in late frames of FA a retreatment was performed. The follow-up period ranged from 6 to 28 months (average - 9.8 months). RESULTS: Visual acuity improved in 22 (30.1%) eyes, stabilized in 34 (46.6%) and deteriorated in 17 (23.3%). Fluorescein angiography showed no CNV leakage in 58 (79.5%) eyes. In 56 (71.8%) with regression of leakage in fluorescein angiography improvement or stabilization of visual acuity was detected. Subretinal haemorrhages after TTT were observed in 4 eyes (5.5%). At the end of the follow-up period fibrosis of CNV was detected in 12 eyes (16.4%). CONCLUSIONS: TTT is effective and safe method of treatment of occult and classic CNV in a course of wet AMD. In a majority of cases TTT results in total or partial regression of CNV and stabilization of visual acuity.     

Transpupillary thermotherapy of occult choroidal neovascularization in age-related macular degeneration

Purpose. To evaluate the efficacy of transpupillary thermotherapy (TTT) in management of occult subfoveal choroidal neovascularization (CNV) in exudative age-related macular degeneration (AMD). Methods. Retrospective chart review of eyes that were treated with TTT and had at least 12 weeks of follow-up. Base-line and final ETDRS visual acuity and fluorescein angiography (FA) were compared. Results. For the 48 eyes which met inclusion criteria, mean pre-operative visual acuity was 20/128 (range: 20/50–20/500). Average follow-up was 27 weeks (range: 12 weeks–55 weeks). At 3 months after treatment, 12 eyes (25%) improved 2 lines or more, 18 eyes (37.5%) had no change or 1 line of visual improvement, and 18 eyes (37.5%) worsened 1 or more lines. No significant adverse event was noted during treatment. Three eyes developed large submacular hemorrhage within 2 months of treatment. Based on clinical examination and FA, 61% of the eyes appeared to have reduction of subretinal fluid compared to pre-operative evaluations. Conclusion. Visual acuity was stable or improved in 62.5% of eyes in our series and the treatment was well tolerated. Longer follow up and larger number of patients would be required to evaluate the ultimate benefit of TTT in management of occult CNV due to AMD.