Transpupillary thermotherapy of occult subfoveal choroidal neovascularization secondary to age related macular degeneration

Transpupillary thermotherapy is a new treatment for subfovealchoroidal neovascularization which needs further evaluation. This study was aimed to evaluate the efficacy of transpupillary thermotherapy on regression of occult subfovealchoroidal neovascularization with or without pigment epithelial detachment in patients with age-related macular degeneration. In a case series study, patients with age-related macular degenerationwho had occult subfoveal choroidal neovascularization less than 4 disc diameterswith or without pigment epithelial detachment underwent transpupillary thermotherapyby diode laser. The patients were followed for 1-12 months. Main outcome measures were visual acuity changes, flattening of pigment epithelial detachment observed clinically, or absence of leakage in angiography. The data were analyzed using T-test and chi- square. The study included 30 eyes of 30 patients. Mean age of the patients was 67±7 years. Mean follow up time was 5.3±0.5 months. Visual acuity improved in63%, remained unchanged in 20%, and worsened in 17%. Mean visual acuity improvedfrom 1.25±0.4 log MAR (20/320) to 1.06±0.36 log MAR (20/200), (p<0.04). Choroidal atrophy or flat scar was achieved in 73% and failure to treatment was seen in 27%, (p =0.0001). Pigment epithelial detachment flattened in all cases after transpupillary thermotherapy. Transpupillary thermotherapy may be a particularly useful modalityfor treating occult subfoveal choroidal neovascularization associated with serouspigment epithelial detachment in selected cases of age-related macular degeneration.