Transpupillary Thermotherapy Of Central Exudative Chorioretinopathy

Background and purpose: Central exudative chorioretinopathy (CEC) is a special group of macular disorders characterized by formation of choroidal neovascularization (CNV), nodular exudation in the macula, recurrent hemorrhage and scar formation in the advanced stage. The purpose of this study was to assess the efficacy of transpupillary thermotherapy (TTT) for the management of CECMethods: In the prospective study, 26 eyes of 26 patients aged --- years with CEC, determined by fundus fluorescein angiography (FFA ) and indocyanine green angiography (ICGA) were treated with 810nm diode laser TTT . Laser beam size ranged from 0.8mm to 2.0mm and power settings ranged between 80mW and 250 mW. Treatment was initiated after focusing at the lesion with the aiming beam for 60 seconds duration. The end-point was an area of no visible colour change. Pre- and post-laser evaluations of best corrected visual acuity(VA), contrast sensitivity, biological ophthalmoscopy, FFA and ICGA were carried out. The follow-up period ranged from 6 to 40 weeks.Results: 1.Of all 26 eyes, 8 eyes (31%) showed improvement and 16 eyes (54%) showed stabilization in best corrected visual acuity at a follow-up of 3 months . The remaining 2 eyes (15%) showed decrease in VA. The difference pre and post-treatment was statistically significant.2. By the TTT treatment in low (1.5,3.0c/d)space-frequency, contrast sensitivity (CS) improved at a follow-up of 1 and 3 month. The statistical analysis showed significant difference (P<0.05) . And middle (6.0c/d) space-frequency, contrast sensitivity (CS) improved at a follow-up of 3 month.In contrast, the CS showed no significant changes (P=0.35) when the eyes were treated in high space-frequency (12.0 and 18.0c/d) 3. At 3 months post-treatment, marked CNV regression determined by FFA was occurred in 20 of 26 eyes and showed no changes in 6 eyes. Of 20 post-treatment eyes checked by ICGA, CNV regressed in 6 eyes and showed smaller in 10 eyes. There is no changes in 4 eyes.Conclusion:1. Transpupillary thermotherapy treatment is a safe and effective strategy for treating idiopathic CNV. Regression of CNV and stabilization and improvement of VA were noted in most treated-eyes.2. Power settings could be optimized based on size of lesion, leakage and hemorrhage. The power setting (spot diameter: 0.8-2.0mm; power setting: 80-250mm) used in this study is much lower that what is used at abroad (spot diameter: 1.2-3.0mm; power setting: 360-10000mw).3. Compared with visual acuity, Contrast Sensitivity is a more sensitive and accurate maker which indicats improvement of visual function pre-and post-treatment.