Transpupillary Thermotherapy in Chinese Patients with Choroidal Neovascularization Secondary to Age-Related Macular Degeneration: Emphasis on the Influence of Power SettingKuo H.-K. · Kao M.-T. · Chen Y.-J. · Chen C.-H. · Wu P.-C. · Kao M.-L.
aDepartment of Ophthalmology, Chang-Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, and bChang-Gung University College of Medicine, Taoyuan, Taiwan
Purpose: To perform a safety and efficacy study of transpupillary thermotherapy (TTT) in Chinese patients with choroidal neovascularization (CNV) secondary to age-related macular degeneration (ARMD). Methods: In a prospective study, patients with subfoveal or juxtafoveal CNV secondary to ARMD underwent TTT with fixed treatment and follow-up protocols. From August 2002 to December 2004, 26 patients (27 eyes) completed ≧6 months of follow-up and were included in this report. Results: Fourteen eyes (52%) had improved or stable visual acuity (loss of <3 lines) and 13 eyes (48%) had vision loss of ≧3 lines. The serial mean visual acuity initially decreased during follow-up, then stabilized by 6 months. In the subgroup of occult or minimally classic CNV (20 eyes), 13 eyes (65%) had improved or stable vision. The major complication of TTT included laser-related retinal pigment epithelium (RPE) atrophy in 10 eyes (37%). Six eyes had mild RPE atrophy, 4 eyes had severe RPE-choroid atrophy (macular burn). Analysis of possible risk factors for macular burn showed that 3 eyes had to have the power amplified due to nuclear sclerosis, and 1 pseudophakic eye had regular power. Conclusions: TTT in Chinese ARMD patients with occult or minimally classic CNV, according to our protocol, prevented severe vision loss in the majority of patients, but power amplification due to medium lens opacity induced RPE atrophy or burn in some patients.
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