Br J Ophthalmol 2001;85:708-713
( June )
Yellow dye laser thermotherapy of choroidal neovascularisation in
age related macular degeneration
Margo R Beintemaa, Jendo A Oosterhuisb, Fred Hendriksea
a University Eye
Department, Maastricht, Netherlands, b Leiden University Medical Centre,
Netherlands
Correspondence to: M R Beintema, Department of Ophthalmology, Academic Hospital
Maastricht, PO Box 5800, 6202 AZ Maastricht, Netherlands
mbei{at}soog.azm.nl
Accepted for publication 24 January 2001
AIM
A pilot study of
the feasibility of using dye laser thermotherapy (LTT) at a
subcoagulation temperature to occlude newly formed vessels in patients
with age related macular degeneration (AMD).
METHODSChoroidal
neovascularisation (CNV) in 24 eyes with exudative AMD was treated with
a continuous wave yellow laser at 578 nm. Parameters were an exposure
time of 2 or 5 seconds, a spot size of 750 or 1000 µm, and a laser
power of 100-200 mW. The clinical end point was a greyish
discoloration at the treatment site. The effect of thermotherapy was
documented by ophthalmoscopic and fluorescein angiographic examination.
The follow up after LTT was 4-16 months, mean 5 months.
RESULTSLTT resulted
in total occlusion of newly formed vessels in 15 eyes (62.5%).
Neovascular outgrowth within 6 weeks and recurrences 2-4 months after
LTT were observed, each in three eyes. In six of the nine eyes with
occlusion of CNV without recurrence the choriocapillaris remained
perfused; in two eyes only the large choroidal vessels remained
perfused. In six eyes pigmentary changes were the only ophthalmoscopic
and fluorescein angiographic signs of treatment. The effect of LTT is
rather unpredictable.
CONCLUSIONCNV in AMD
can effectively be treated by yellow dye laser thermotherapy with
preservation of choroidal perfusion. The technique requires dosimetric adaptation.
© 2001 by British Journal of Ophthalmology
