TTT for occult CNV: check the power!

Mueller, Andreas; Ulbig, Michael W.; Кампик, А

doi:10.1136/bjo.86.10.1194

Cited by 4 publications

(3 citation statements)

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“…As a treatment method, TTT is low cost, causes little discomfort for the patient and has few side-effects, although a few cases of over-treatment and epithelial tears have been reported, as has detachment of the membrane itself (Ahuja et al 2001;Thompson 2001;Benner et al 2002;Rumelt et al 2002;Salinas-Alaman et al 2003;Benhamou et al 2004;Gustavsson & Agardh 2004). Several studies have been performed since, some of which have suggested a positive effect (Ahuja et al 2001;Algvere et al 2001Algvere et al , 2003Friberg et al 2001;Kim et al 2001;Newsom et al 2001;Park et al 2001;Thach et al 2003), while others have been more negative (Mueller et al 2002;Haas et al 2003). As none of these studies included a control group, the aim of the present project was to perform a prospective, randomized, controlled study on the efficacy of TTT versus sham treatment for occult subfoveal CNV.…”

Section: Introductionmentioning

confidence: 99%

Transpupillary thermotherapy for occult subfoveal choroidal neovascularization: a 1‐year, prospective randomized pilot study

Gustavsson

Agardh

2005

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To evaluate the 1-year effect of transpupillary thermotherapy (TTT) on occult choroidal neovascularization membranes (CNV). Methods: In this prospective, randomized, controlled pilot study of 28 patients with occult or minimally classic (< 10%) neovascularization membranes with a diameter less than 4500 mm, 19 patients were treated with TTT, while nine received sham treatment. Outcome measures were membrane diameter, visual acuity and reading ability. Results: The median age of patients randomized to TTT was 78 years (range 24 years); that of patients randomized to sham was 79 years (range 9 years). There was no difference regarding membrane diameter at baseline between the two groups; the median membrane diameters were 3400 mm (range 2400 mm) in the TTT group and 3200 mm (range 2300 mm) in the sham group (p ¼ 0.639). Visual acuity (VA) was similar, with a median of 0.2 (minimumÀmaximum 0.08À0.5) in the TTT group and a median of 0.16 (minÀmax 0.10À0.32) in the sham group. A total of 21 patients were followed for 1 year, 13 in the TTT group (2.7 treatments/patient) and eight in the sham group. Membrane diameter increased in both groups, by a median of 350 mm (range 1600 mm) in the TTT group and 800 mm (range 1700 mm) in the sham group (p ¼ 0.414), respectively, and there was a loss in VA of ! 15 letters in 5/13 patients (38%) in the TTT group compared with 2/8 patients (25%) in the sham group (p ¼ 0.266). Reading ability deteriorated equally over time in both groups. Seven patients were lost to follow-up due to reluctance to continue in the study (n ¼ 4) or development of a classical component > 50% (n ¼ 3) requiring photodynamic therapy (PDT). Conclusion:The results from this randomized, prospective pilot study of TTT for occult CNV did not indicate that TTT has a beneficial effect on visual outcome 1 year after treatment compared with the visual outcome that results from the natural course of the disease. The small study size limits statistical power and results from large control studies are needed.

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Section: Introductionmentioning

confidence: 99%

Transpupillary thermotherapy for occult subfoveal choroidal neovascularization: a 1‐year, prospective randomized pilot study

Gustavsson

Agardh

2005

Acta Ophthalmologica Scandinavica

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“…Over-dosage may result in irreversible changes with PDT or TTT treatment. Under-dosage will not give positive results of the treatment 6 .…”

Section: Introductionmentioning

confidence: 99%

Laser microradar technique for eye fundus investigation

Molebny¹

2003

SPIE Proceedings

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Current treatments for vascular disorders in retina include laser surgery and laser therapy to eliminate the crucial influence of abnormal blood vessels. Three alternatives are in use: laser photocoagulation surgery, photodynamic therapy, and transpupillary laser thermotherapy. Even sophisticated laser-based devices and arrangements, in practice today, do not solve the problem of adequate dosage of the irradiation, that is an extremely critical matter. As an indirect source of information about the temperature and irradiation dosage, the changes of relief during tissue heating are proposed to be used. Temperature difference between treated and untreated zones achieves 10°C and more. The growth of temperature of the irradiated tissue leads to dimension changes, and thus to the changes of the topography of eye bottom. We studied a known phase difference double-beam interferometric technique modified in such a way, that a reference beam is kept in a reference position without scanning. A second, frequency-shifted beam is scanned along a trajectory crossing treated and untreated zones of the eye bottom. Changes in phase structure are analyzed to have a judgement on thermal processes in retina. Experimentally, eye model was used with a retina movable by means of a micro-screw. Sensitivity of the order of 0.1 µm was got. We recommend further studies on a live tissue, affected by laser radiation.

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“…Currently available treatment options for AMD-related CNV include laser photocoagulation [30], photodynamic therapy [9], transpupillary thermotherapy [21] and surgical interventions such as macular rotation or CNV extraction [26]. Several new pharmacologic therapies are emerging.…”

Section: Introductionmentioning

confidence: 99%