Transpupillary thermotherapy for subfoveal occult choroidal neovascularization: Effect on ocular perfusion

PURPOSE. To perform a descriptive analysis of the effects on ocular blood f low of transpupillary thermotherapy TTT for occult subfoveal choroidal neov ascular membranes (CNVMs) in age-related macular degeneration (AMD). METHODS. Eleven subjects with occult subfoveal CNVM due to AMD were assesse d in a masked fashion by color Doppler imaging (CDI) within 24 hours before , 24 hours after, and 1 month after undergoing TTT. RESULTS. In the posterior ciliary arteries (PCAs), there were no statistica lly significant changes observed in the peak systolic velocity (PSV), end d iastolic velocity (EDV), or resistive index (RI) at 24 hours. At 1 month, t he mean EDV decreased 36% (P = 0.0105) and the mean RI increased 3.8% (P = 0.0305) in the nasal PCA. Although there was a similar trend in the tempora l PCA, the differences did not reach statistical significance. In the centr al retinal artery (CRA), the mean PSV decreased 16% (P = 0.0137), and the m ean EDV decreased 21% (P = 0.0222) at 24 hours after treatment. There were no statistically significant differences in the CRA blood flow indices at 1 month after treatment. in the ophthalmic artery, there were no statistical ly significant differences observed in the mean PSV, EDV, or RI at 24 hours or 1 month after treatment. CONCLUSIONS. TTT is associated with transiently decreased volumetric blood flow in the retinal circulation 24 hours after treatment. In the posterior ciliary arteries that supply the choroid, there were no changes observed at 24 hours, but at 1 month, there was a decrease in the mean EDV and an incr ease in the RI in the nasal and temporal PCAs, reaching statistical signifi cance in the nasal PCA only. This study suggests that TTT could lead to alt erations in choroidal blood flow, as assessed by CDI. Further study is warr anted.