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Macular infarction a possible complication of TTT

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SALISBURY, Md. — Macular infarction is a possible but rare complication of transpupillary thermotherapy for subfoveal choroidal neovascularization, according to surgeons here. The presence of geographic retinal pigment epithelium atrophy or a previous laser treatment scar in the macular region may predispose patients to the complication, the surgeons said.

Jeffrey D. Benner, MD, and colleagues reviewed a series of 107 patients who underwent transpupillary thermotherapy (TTT) for subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration. Two of the patients noted a severe decrease in visual acuity and photopsias within hours of undergoing TTT.

Both patients had marked whitening of the macula on clinical exam and closure of the perifoveal capillaries on fluorescein angiography. Immediately after treatment, visual acuity decreased from 20/200 to 6/200 and from 20/400 to 2/200. Several months later, however, all exudation had resolved and the patients' visual acuity had stabilized at 20/100 and 20/200.

The study is published in the November issue of American Journal of Ophthalmology.