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I. A. Barbazetto, R. Iranmanesh, J. Klancnick, B. P. Maar, T. Lee, D. H. Abramson; Photodynamic Therapy for Recurrent, Amelanotic, Choroidal Melanoma. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5707.
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The aim of this study was to determine the clinical outcomes and safety profile of photodynamic therapy (PDT) as a treatment for recurrent, amelanotic melanoma.
Retrospective, noncomparative case series of patients treated with PDT (verteporfin, 6 mg/m2BSA) for recurrent, amelanotic melanoma. Number of treatments, tumor response on clinical examination and ultrasonography, visual acuity and adverse events were evaluated.
A total of 10 eyes of 10 patients (5 male, 5 female; average age: 59 years) were treated. All patients had persistent or recurrent tumor growth after previous plaque or proton beam therapy with an average time between radiation and PDT of 20.8 months (0 - 52 months). Patients received a total of 1 to 3 treatments (average: 1.7) with 1 to 7 partially overlapping treatment spots depending on tumor size and configuration. Tumor reduction was achieved in all but one patient. One patient decided to undergo enucleation within three month after PDT, a second patient was enucleated 11 months following the last PDT treatment for continued tumor growth around the optic nerve. Two patients experienced a recurrence 6 months after initial complete tumor regression. Treatment was usually well tolerated. Moderate (4 patients) to severe (1 patient) eye pain was the most common adverse event after treatment, followed by transient peri-ocular edema (4 patients). Patients with larger tumor size and treatment area were more likely to experience pain and swelling. Retinal and/or vitreous hemorrhages were observed in seven patients. Significant visual loss ( > 6 lines) was encountered by 3 patients. Three patients presented with new or increasing, transient, serous retinal detachments. Insufficient control of tumor margins was the most common reason for repeated PDT applications (6 patients).
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