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V. A. Kon-Jara, J. Colina, R. Bueno, G. Haffner, N. A. Chaudhry, P. E. Liggett; Ranibizumab + TTT-ICG Based Photodynamic Therapy in the Treatment of Choroidal Melanoma. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5761.
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To evaluate safety and tolerability of Ranibizumab + TTT - ICG based PDT for Treatment of Choroidal Melanoma (CM).
8 consented patients have met inclusion criteria. A complete ophthalmological evaluation were performed, including A-B scan and FA examination proven small and medium size CM. Patients have been recruited in a single-center for a non-randomized, open-label, active treatment study of intravitreal Ranibizumab combined with TTT + ICG-based PDT. Systemic evaluation by a PCP included chest X-ray, serum liver enzyme levels, and abdominal CT. All cases receive 0.5 mg ranibizumab every 30 days (+/- 7 days) per 6 months and one or a maximum of two sessions of TTT at the 1st and 2nd month respectively, with follow-upv(F/U) every 4 weeks during first 7 months. Outcome measures are regression of vessels and decrease in tumor size or appearance documented by fundus pictures, FA, OCT and A-B scan, VA changes and adverse events.
2 males, 6 females. 2 patients have completed 12 months of F/U, the others have more than 6 months of F/U. The median age was 69.25 years. The patients received a mean range of 6 intravitreal injections during F/U and 1.25 session of TTT. VA was very stable as well as OCT findings. Complications were subconjunctival hemorrhage at the injection site in 8 patients, CME in one patient and other patient revealed perivascular hemorrhage after laser. One patient showed lost of VA because the tumor lesion was close to the fovea. A scan showed increased reflectivity and B scan revealed decreased tumor size. Systemic adverse events or recurrence were not seen.
The combined treatment of CM seems to be safe, tolerable and effective achieving local tumor control, but further studies and longer F/U are needed..
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