Results 28 months following transpupillary thermotherapy for classic and occult choroidal neovascularization in patients with age-related macular degeneration

Background and objective: To report the outcome of patients 28 months following treatment with transpupillary thermotherapy (TTT) for classic and occult choroidal neovascularization (CNV) secondary to age-related macular degeneration. 

Patients and methods: A nonrandomized pilot trial of 36 eyes of 33 patients was performed. Eyes with angiographically defined CNV, 11 predominantly classical and 25 predominantly occult, were treated with large spot diode laser (810 nm) TTT for 1 minute, the end point being no or minimal visible change. Outcome was assessed with best-corrected LogMAR visual acuity, clinical examination, and fluorescein angiography. 

Results: Patients were observed for a mean of 28.7 months (range, 18 to 40 months). The mean change in LogMAR visual acuity for predominantly classic membranes was -1.91 (standard deviation [SD] = 4.3) and 5 of 11 (45.5%) eyes had a loss of 3 or more LogMAR lines. Predominantly classic membranes were closed in 9 of 11 eyes and stabilized in 2 of 11 eyes. The mean change in LogMAR visual acuity for predominantly occult membranes was -1.48 (SD = 6.3) and 10 of 25 (40%) patients had a loss of 3 lines or more. Predominantly occult CNV was stabilized in 25 of 25 cases, and recurrence developed in 2 of 25 cases; one of the latter developed classic CNV. 

Conclusions: The medium-term results for patients treated with TTT for both occult and classic CNV show good stability, with little visual loss and few recurrences. These data confirm the original findings of this study.