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

PURPOSE: 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). DESIGN: Interventional case reports. METHODS: 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 de crease in visual acuity and photopsias within hours of undergoing TTT. RESULTS: 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. CONCLUSIONS: 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. (C) 2002 by Elsevier Science Inc. All rights reserved.