Transpupillary thermotherapy for choroidal melanoma: tumor control and visual results in 100 consecutive cases

Ophthalmology
Carol L ShieldsG Mercado

Abstract

The authors evaluated the results of primary transpupillary thermotherapy for choroidal melanoma in 100 cases. Prospective nonrandomized analysis of treatment method. One hundred patients with choroidal melanoma were studied. Tumor response, ocular side effects, and visual results. Of 100 consecutive patients with choroidal melanoma treated with transpupillary thermotherapy, the mean tumor basal diameter was 7.1 mm and tumor thickness was 2.8 mm. The tumor margin touched the optic disc in 34 eyes (34%) and was beneath the fovea in 42 eyes (42%). Documented growth was present in 64 eyes (64%), and known clinical risks for growth were present in all of the remaining 36 eyes (36%), with an average of 4 of 5 statistical risk factors for growth per tumor. After a mean of three treatment sessions and 14 months of follow-up, the mean tumor thickness was reduced to 1.4 mm. Treatment was successful in 94 eyes (94%) and failed in 6 eyes (6%). Three patients with amelanotic tumors showed no initial response to thermotherapy, but subsequent intravenous indocyanine green administration during thermotherapy resulted in improved heat absorption and tumor regression to a flat scar. The six eyes classified as treatment failures included four ey...Continue Reading

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