Transpupillary Thermotherapy
Transpupillary thermotherapy (TTT) is a procedure that uses heat from a lower powered laser to coagulate the leaky blood vessels. TTT uses the laser for longer periods of time and is designed to slowly heat the spot where the bleeding is occurring. Because it is using low heat, damage to the
retinal pigment epithelium
(RPE) is minimized.
How does TTT Work?
The laser works by raising the temperature in the RPE which leads to vessel coagulation. The goal is to stop the growth and leakage of new blood vessels. TTT is usually performed in the doctor's office under local anesthesia. The aim of the treatment is to preserve existing vision and not to improve vision. There are two types of wet macular degeneration. They are: 1)
Classic Meo-vascularization
(seen), or
2)
Occult Neo-Vascularization
(hidden).
This macular degeneration therapy is used to treat patients with occult new vessels. Over 70% of people with
wet macular degeneration
have the occult type.
TTT is considered investigational as a treatment for
choroidal neovascularization
and is not usually covered by insurance.
Clinical Trials using TTT
1) The Ranibizumab Plus Transpupillary Thermotherapy for Neovascular AMD Study
They hyopthesis of this study in Stockholm, Sweden is "that when
ranibizumab (Lucentis)
is combined with transpupillary themotherapy (TTT) the number of necessary retreatments with Lucentis will be significantly reduced as compared to ranibizumab alone.
2) TTT Versus PDT for Treatment of Choroidal Neovascularization in Age-Related Macular Degeneration
The purpose of this study, also in Stockholm, Sweden is "to compare
photodynamic therapy
to TTT as a treatment method for
choroidal neovascularization
in age-related macular degeneration." As of January 2010, this study was terminated due to difficulties in recruiting patients.
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Contact Leslie Degner, RN, BSN
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