Transpupillary Thermotherapy in Age Related Serous Detachment of the PigmentEpithelium

Czech version

Authors: I. Karel ¹; J. Záhlava ¹; J. Boguszaková ²; Z. Dubská ³; J. Lešták ¹
Authors‘ workplace: Oční klinika JL, Praha, primář MUDr. J. Lešták, CSc. 2Katedra oftalmologie IPVZ, Praha, přednosta prof. MUDr. J. Boguszaková, DrSc. 3Oční klinika VFN a 1. LF UK, Praha, přednosta doc. MUDr. M. Filipec, CSc. ¹
Published in: Čes. a slov. Oftal., , 2004, No. 2, p. 89-97
Category:

Overview

The goal of this prospective study was to evaluate results of the transpupillarythermotherapy (TTT) in the age relatedmacular degeneration (ARMD) where theserous detachment of the pigment epithelium (SDPE) was the dominant sign.Material and methods: Thirty eyes of 29 patients were treated by TTT. All patientswere examined before and 3, 6, 9, 12, 18, and 24 months after TTT in terms of visualacuity (VA), indirect binocular ophthalmoscopy, and indirect slitlamp biomicroscopy,fluorescein angiography, and optic coherent tomography (OCT) of the macularregion. In 25 eyes (83,3 %) signs of choroidal neovascularization (CNV) werepresent (vascular SDPE). TTT was performed with a standard technique by diodelaser (wavelength 810 nm). In 14 eyes (46.7 %) the TTT procedure was repeatedafter 3 to 38 weeks. The follow-up period was 7 to 28 month (mean 15.2 months). Results: AfterTTT,VAimprovedin6 eyes (20.0 %),remained stable in 8 eyes (26.7 %),and deteriorated in 16 eyes (53.3 %). Indirect slitlampbiomicroscopy revealed, thatthe SDPE re-attached in 13 eyes (43.3 %), decreased in size in 12 eyes (40.0 %);fluorescein leakage disappeared in 16 eyes (53.3 %) and was reduced in 10 eyes(33.3 %). By OCT, the re-attachment of SDPE was confirmed in 14 eyes (46.7 %) andit’s reduction in 13 eyes (43.3 %). The leading cause of the same or worse VA afterdiminishing of SDPE was chorioretinal atrophy, with or without subretinal fibrosis.Conclusion: In the long term, the TTT led to the decline of SDPE in the majorityof eyes and improved or stabilized VA in nearly one half of eyes. In most cases,signs of neovascularization were present. After the SDPE regression, the chorioretinalatrophy prevented the better functional results. TTT is not economicallyexpensive and widens treatment possibilities in exsudative form of ARMD includingSDPE.

Key words:
Transpupillary thermotherapy (TTT), age related macular degeneration(ARMD), serous detachment of the pigment epithelium (SDPE)

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