Early vascular changes induced by transpupillary thermotherapy of choroidal neovascularization

Ophthalmology. 2002 Jun;109(6):1098-104. doi: 10.1016/s0161-6420(02)01034-5.

Abstract

Objective: To study early direct effects of transpupillary thermotherapy (TTT) on choroidal neovascularization (CNV) and choroid.

Design: Retrospective, noncomparative interventional case series.

Participants: Sixty-four eyes with subfoveal CNV.

Intervention: TTT was delivered using a diode laser at 810 nm through a contact lens. Exposure time was 60 seconds with a power/diameter ratio of 247 mW/mm. The end point was an invisible treatment with no color change at the retina level.

Main outcome measures: Fluorescein and indocyanine green angiographic findings within 1 hour, and at 1, 2, and 4 weeks after TTT.

Results: Fluorescein angiography (FA) and indocyanine green angiography (ICGA) performed within 1 hour after TTT showed increased leakage of CNV and choroidal vessels. Follow-up at 1 and 2 weeks demonstrated a hypofluorescent area corresponding to the laser spot and absence of angiographic leakage seen on FA and ICGA. At 4 weeks after TTT, FA showed mottled hypofluorescence-hyperfluorescence of the TTT-treated area and absence of angiographic leakage.

Conclusions: TTT induces a characteristic dynamic sequence of vascular changes. Treatment with TTT can lead to absence of angiographic (FA and ICGA) leakage for 4 weeks. Determination of the long-term efficacy and visual implications awaits the results of clinical trials.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Flow Velocity
  • Capillary Permeability
  • Choroid / blood supply*
  • Choroidal Neovascularization / diagnosis
  • Choroidal Neovascularization / physiopathology*
  • Choroidal Neovascularization / therapy*
  • Female
  • Fluorescein Angiography
  • Humans
  • Hyperthermia, Induced / methods*
  • Indocyanine Green
  • Laser Therapy
  • Male
  • Middle Aged
  • Pupil
  • Retrospective Studies

Substances

  • Indocyanine Green