Macular burn after transpupillary thermotherapy for occult choroidal neovascularization

Abstract

PurposeTo report a case of severe macular burn as a complication of transpupillary thermotherapy treatment for occult choroidal neovascularization. DesignInterventional case report. MethodsA 65-year-old man developed a severe macular burn following transpupillary thermotherapy treatment. ResultsBefore treatment, fluorescein angiography and indocyanine green angiography showed a progressive, ill-defined leakage corresponding to the presence of occult choroidal neovascularization. One month after treatment, fundus examination disclosed macular atrophy. The early phases of fluorescein angiography and indocyanine green angiography showed that the macular choroidal filling time had worsened dramatically. At the late phase of indocyanine green angiography, the initial hyperfluorescence of choroidal neovascularization was replaced by a persistent, markedly hypofluorescent area. ConclusionProlonged choroidal filling may be a risk factor for macular burn and choroidal occlusion after transpupillary thermotherapy. In such cases, we suggest that transpupillary thermotherapy should be considered with caution and, when applied, that its intensity should be reduced.