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

Background: Transpupillary thermotherapy is a new treatment for subfoveal choroidal neovascularization which needs further evaluation. This study was aimed to evaluate the efficacy of transpupillary thermotherapy on regression of occult subfoveal choroidal neovascularization with or without pigment epithelial detachment in patients with age-related macular degeneration. Methods: In a case series study, patients with age-related macular degeneration who had occult subfoveal choroidal neovascularization less than 4 disc diameters with or without pigment epithelial detachment underwent transpupillary thermotherapy by 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 chisquare. Results: 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 in 63%, remained unchanged in 20%, and worsened in 17%. Mean visual acuity improved from 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. Conclusion: Transpupillary thermotherapy may be a particularly useful modality for treating occult subfoveal choroidal neovascularization associated with serous pigment epithelial detachment in selected cases of age-related macular degeneration.