Long–term follow up of 50 patients treated with transpupillary thermotherapy (TTT) for malignant choroidal melanoma

Abstract

Abstract: : Purpose: For the treatment of small choroidal melanomas (< 3.0 mm) or residual tumors after brachytherapy transpupillary thermotherapy (TTT) has been used increasingly. Methods: 50 patients with a small primary malignant melanoma (<3.0 mm, 24 patients) or after previous brachytherapy (26 patients) were treated with transpupillary thermotherapy. Infrared diode laser light at 810 nm was used to apply laser spots of about 3000µm. Laser energy ≥800mW was needed to achieve visible effects after 60 seconds duration. A complete ophthalmic examination including visual acuity, slit–lamp biomicroscopy, funduscopy, ultrasound and fluorescein angiography was performed prior to and after the treatment. Results:After 30 months, in 44 (88%) patients a complete occlusion of the treated tumor vessels was observed. In 6 (12%) patients a residual tumor activity could be identified by fluorescein angiography. In 19 patients TTT had to be performed only one time to reach a complete reduction of the tumor, the remaining 31 patients received a repeated TTT treatment without any complications. After TTT visual acuity remained stable in 44 (88%) patients. Conclusions:Transpupillary thermotherapy has been proven to be an effective and save therapy for patients with residual tumor or small choroidal melanoma. During the observed period none of the patients required enucleation and only three patients needed one additional brachytherapy.

Keywords: melanoma • laser • choroid