Quantitative fluorescein angiography following diode laser retinal photocoagulation

Transpupillary thermotherapy (TTT) is a subthreshold, low irradiance, long exposure duration, large spot size, infrared diode laser protocol. Retinal temperature increases in TTT for choroidal neovascularization (CNV) are substantially lower than those in conventional short-pulse photocoagulation, but they are maintained for 60 seconds to achieve therapeutic results. Treatment power is adjusted for retinal lesion size, chorioretinal pigmentation, macular elevation and media clarity. TTT uses 810-nm diode laser infrared radiation, which has no significant retinal phototoxicity. A parfocal laser delivery system is required to assure uniformity of irradiance across large diameter treatment spots. Relative contraindications for TTT include dense subretinal hemorrhage, prior focal photocoagulation and serous RPE detachment. Adverse events are rare, and include decreased vision and retinal arteriole occlusion. Randomized, prospective multi-center trials are underway to compare the results of TTT for occult CNV in age-related macular degeneration to the natural history of the disorder. Imaging, electrophysiologic or thermometric techniques may ultimately provide intra-operative or post-operative monitoring to assure the adequacy of TTT for CNV, despite the absence of ophthalmoscopically visible lesions.

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Monitoring Retinal Function during Transpupillary Thermotherapy for Occult Choroidal Neovascularization in Age-Related Macular Degeneration

Falsini

Focosi

Molle

et al. 2003

Invest. Ophthalmol. Vis. Sci.

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fERG amplitude decreases transiently during TTT, despite the absence of ophthalmoscopically apparent lesions. Intraoperative amplitude depression may result from an adaptation effect to laser light energy and/or hyperthermia, resulting in desensitization of cone photoreceptors and bipolar cells. Treatment sites are electrophysiologically functional 1 month after TTT. Detailed parametric study of a larger patient group is needed to determine whether fERG testing is potentially useful for monitoring and perhaps for controlling and optimizing TTT for choroidal neovascularization.

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Quantitative fluorescein angiography following diode laser retinal photocoagulation

Cited by 4 publications

References 16 publications

Quantitative Fluorescein Angiography

Quantitative Fluorescein Angiography

Transpupillary thermotherapy for age-related macular degeneration: Principles and techniques

Monitoring Retinal Function during Transpupillary Thermotherapy for Occult Choroidal Neovascularization in Age-Related Macular Degeneration

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