Transpupillary thermotherapy for the treatment of choroidal neovascularization secondary to angioid streaks

Can J Ophthalmol. 2007 Feb;42(1):95-100.


Background: To investigate the effect of transpupillary thermotherapy (TTT) on choroidal neovascularization (CNV) secondary to angioid streaks.

Methods: Six eyes of 5 patients with an average age of 61 years were diagnosed to have subfoveal CNV secondary to angioid streaks. Four of the CNVs were predominantly classic and 2 were occult with no classic. Visual acuity (VA) measurement, ophthalmoscopic and fluorescein angiographic examination, and optic coherence tomography (OCT) were carried out before TTT treatment and at each follow-up visit. Activity scores (AS) based on clinical, angiographic, and OCT findings were also recorded.

Results: The mean follow-up was 12 months. The VA initially ranged from counting fingers to 20/100 and remained stable in all patients. The mean greatest lesion diameter increased significantly from 2221 microm to 3109 microm at last follow-up (p=0.046). The mean AS decreased significantly from 6.5 to 4.8 at the 3rd month (p=0.039), but tended to increase thereafter. Retreatment with TTT was applied to 5 eyes after a mean of 7.8 months but did not decrease CNV activity as effectively as the first treatments. A fibrotic scar developed in 1 eye after the first treatment.

Interpretation: TTT may decrease the activity of CNVs secondary to angioid streaks in the short term, but retreatment may be necessary with unfavorable results. TTT appears to stabilize VA but not lesion size in this group of patients, which may be the natural history rather than a treatment effect.

MeSH terms

  • Aged
  • Angioid Streaks / complications*
  • Choroidal Neovascularization / diagnosis
  • Choroidal Neovascularization / etiology
  • Choroidal Neovascularization / therapy*
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced / methods*
  • Male
  • Middle Aged
  • Pupil
  • Retreatment
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity