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  Česky / Czech version Čes. a slov. Oftal., 58, 2002, No. 4, p. 215 - 223
 
Transpupillary Thermotherapy in Age-Related Macular Degeneration 
Karel I.1, Záhlava J.1, Boguszaková J.2, Dubská Z.3, Lešták J.1 

1Privátní oční oddělení, Praha 5, primář MUDr. J. Lešták, CSc. 2Katedra oftalmologie IPVZ, Praha, vedoucí prof. MUDr. J. Boguszaková, DrSc. 3Oční klinika VFN a 1. LF UK, Praha, přednosta doc. MUDr.M. Filipec, CSc.
 


Summary:

       Objective. To evaluate anatomical and functional results of transpupillary thermotherapy (TTT) in age-related macular degeneration (ARMD) with a chorioid neovascular membrane (CNVM). Material and methods. TTT was performed by means of a diode laser (Iris Medical Oculight Six) in 38 eyes of 35 patients aged 46-93 years, mean 70.6 years. Ocult CNVM was treated in 34 eyes, classical CNVM in 4 eyes. In TTT we applied 1 to 5 points (on average 1.9 spot) and used a laser beam with a diameter of 0.5-3 mm (mean width 1.61 mm). In 10 eyes with occult CNVM (29%) TTT was repeated after 1-6 months. The patients were followed up after TTT for 6-18months on average for 9.5 months. Results. The final visual acuity (VA) improved after TTT in two eyes (5.3 %), remained unchanged in 22 eyes (57.9 %) and deteriorated in 14 eyes (36.8 %). The mean VA after TTT declined from 0.23 to 0.17. Biomicroscopic manifestations of exudation disappeared or receeded in 29 eyes with occult CNVM (85.3 %) and in 3 eyes with classical CNVM (75%). Fluoroangiographic examination revealed a reduced or absent extravasation of the dye in 24 eyes with occult CNVM (70.5 %) and in 3 eyes with classical CNVM (75%). Optic coherent tomography confirmed regression of exsudative changes and the development of a chorioretinal scar in 23 eyes with occult CNVM (67.6 %) and 3 eyes with classical CNVM (75 %). Conclusion. TTT is a new potential therapy of ACMD with CNVM. It is indicated in particular in occult CNVM. It can be however used also in classical CNVM. TTT is not economically pretentious and can be used also in other than large clinical departments. It is important to test the possibilities and limitations of TTT on a large number of patients and assess its position among other therapeutic procedures.

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