Macular infarction after transpupillary thermotherapy for subfoveal choroidal neovascularization in age-related macular degeneration.

Abstract

To report the complication of macular infarction after transpupillary thermotherapy (TTT) for the treatment of subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). Interventional case reports. Among 107 consecutive patients with subfoveal CNV due to AMD, a 73-year-old woman with recurrent subfoveal classic choroidal neovascularization and a 76-year-old man with subfoveal occult choroidal neovascularization with adjacent areas of geographic retinal pigment epithelium atrophy noted a severe decrease in visual acuity and photopsias within hours of undergoing TTT. Both patients had marked whitening of the macula clinically and closure of the perifoveal capillaries on fluorescein angiography. Immediately after treatment their visual acuity decreased from 20/200 to 6/200 and from 20/400 to 2/200, respectively. Several months later, all exudation had resolved and their visual acuity had stabilized at 20/100 and 20/200, respectively. Macular infarction is a rare complication that occurred in two of 107 patients undergoing TTT for subfoveal CNV due to AMD. The presence of geographic retinal pigment epithelium atrophy or a previous laser treatment scar in the macular region may predispose patients to this complication.