Transpupillary thermotherapy of retinal angiomatous proliferation in age-realetd macular degeneration

Purpose:To report on the treatment of retinal angiomatous proliferation (RAP) in age-related macular degeneration (AMD) by means of transpupillary thermotherapy. Methods:20 consecutive patients affected by RAP in AMD were treated using a one session, two-shot, subthreshold transpupillary thermotherapy technique, developed according to the principle of thermoresitance of tissues. Treated eyes were examined one week and one month after treatment, and then at three month interval. Best corrected visual acuity (BCVA) , fundus photographs, dynamic fluorescein and indocyanine green angiography were performed at each follow-up examination. Results: Mean follow-up was 6 months (range 3-24 months) . BCVA decreased (more than 3 lines) in 30% of eyes (6 eyes) , and remained stable in 14 eyes (70%). No eye had improvement of BCVA. Reduced leakage and closure of RAP were observed in all eyes at early follow-up. After 3 months, RAP was patent in 75% of eyes, but leakage was significantly and permanently reduced. Conclusion: One session, subthreshold, two-shot transpupillary thermotherapy may prove useful in the treatment of RAP in AMD, a currently untreateble clinical condition.