April 2009
Volume 50, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2009
Photodynamic Therapy for Amelanotic Choroidal Melanoma Unresponsive to Standard Treatment Modalities
P. Valente; M. A. Blasi; A. Scupola; G. Savino; E. Midena; A. C. Tiberti; E. Balestrazzi
Author Affiliations & Notes
  • P. Valente
    Department of Ophthalmology, Catholic University of Rome, Rome, Italy
  • M. A. Blasi
    Department of Ophthalmology, University of L'Aquila, L'Aquila, Italy
  • A. Scupola
    Department of Ophthalmology, Catholic University of Rome, Rome, Italy
  • G. Savino
    Department of Ophthalmology, Catholic University of Rome, Rome, Italy
  • E. Midena
    Department of Ophthalmology, University of Padova, Padova, Italy
  • A. C. Tiberti
    Department of Ophthalmology, Catholic University of Rome, Rome, Italy
  • E. Balestrazzi
    Department of Ophthalmology, Catholic University of Rome, Rome, Italy
  • Footnotes
    Commercial Relationships  P. Valente, None; M.A. Blasi, None; A. Scupola, None; G. Savino, None; E. Midena, None; A.C. Tiberti, None; E. Balestrazzi, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 3372. doi:
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      P. Valente, M. A. Blasi, A. Scupola, G. Savino, E. Midena, A. C. Tiberti, E. Balestrazzi; Photodynamic Therapy for Amelanotic Choroidal Melanoma Unresponsive to Standard Treatment Modalities. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3372.

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Abstract

Purpose: : Brachytherapy is the most widely used treatment for choroidal melanoma often combined with transpupillary thermotherapy (TTT). The combination of plaque radiotherapy with TTT provides excellent intraocular tumor control with local tumor recurrence of only 3% at 5 years follow-up. Amelanotic melanoma is a tumor responding less to brachytherapy and TTT than darker tumors. The aim of this study is to investigate the effect of photodynamic therapy with verteporfin on amelanotic choroidal melanoma that showed recurence or no response after previous brachytherapy and TTT.

Methods: : an interventional case-series of the effects of PDT was performed in 4 patients with choroidal amelanotic melanoma. PDT was considered as last therapeutic option, before enucleation. PDT was performed using 6 mg/m2 body surface area of verteporfin administered intravenously. The light dose used was 100 J/cm2 at 689 nm, 15 minutes after injection. Biomicroscopy, ultrasound, fluorescein/indocyanine green angiography (FA, ICGA), optical coherence tomography (OCT) were evaluated before treatment and 2 weeks, 1, 3, and every 4 months after treatment.

Results: : following treatment, all tumours decreased in size (mean height pre-treatment 4.53 mm; post-treatment 2.1 mm). All patients showed an improvement in visual acuity. Two patients experienced a transient subretinal haemorrhage. Angiographic features showed ipofluorescence in the treated area due to closure of the tumour vessels. OCT detected a resolution of subretinal and intraretinal fluid with atrophic changes of the retina.

Conclusions: : PDT can become an adjuvant treatment method for amelanotic uveal melanoma. Vascular occlusion and thrombosis in tumor vessel were observed in eyes treated with PDT. Melanin may reduce the photo-oxidative effects of PDT. The high vascular density and the absence of melanina in amelanotic melanoma could explain the efficacy of PDT. Careful long-term follow-up must be performed to determine whether PDT can play a role as supplementary modality in the treatment of choroidal melanoma.

Keywords: melanoma • tumors • uvea 
© 2009, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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