Kociecki J, Pecold K
Katedry i Kliniki Okulistycznej im. Karola Marcinkowskiego w Poznaniu.
Klin Oczna. 1999;101(1):23-7.
The purpose of the study was to evaluate the effectiveness of diode laser transpupillary thermotherapy and to determine in what extent it may act as the only method of therapy of choroidal tumors, and when it should be used in combination with other methods. The study has preliminary character.
15 eyes of 14 patients aged 38 to 82 years (mean--57 years) were treated because of intraocular tumor with the use of diode laser transpupillar thermotherapy in 13 patients primary intraocular tumor was diagnosed, and in 1 patient there was metastasis; in 13 cases tumors were localized unilaterally, whereas in 1 case they appeared in both eyes. The follow-up period (from the start of the treatment) ranged from 1 to 3 months.
All patients were treated with transpupillary thermotherapy (TTT) with the use of diode laser OcuLight SLx, IRIS Medical instruments, Inc. The power and size of the laser spots depended on the tumor size and pigmentation. Mean power used for the treatment was 600 mW, while mean exposure time was 1 minute.
Altogether, within 15 treated eyes in 8 cases regression, in 6--stabilization and in 1--progression was stated. As to complications and side effects, visual field scotomas in the treated area as well as deterioration of visual acuity were found during the treatment. In 2 cases a slight improvement of visual acuity was found.
In selected cases transpupillary thermotherapy (TTT) can be effective especially in regard to small tumors (height up to 4.5 mm). Probably in the future it will be the only method of treatment. Treatment of larger tumors (height more than 4.5 mm) should be connected with the use of ruthenium plaque (106Ru). All complications and side effects found in the course of treatment were not dangerous to the eye (small hemorrhage) and were relatively easily tolerated by the patients. With longer follow-up of greater group of patients probably it will be possible to establish optimal parameters, advantages and possible other complications of such therapy.
本研究旨在评估二极管激光经瞳孔温热疗法的有效性，并确定其在多大程度上可作为脉络膜肿瘤的唯一治疗方法，以及何时应与其他方法联合使用。本研究具有初步性质。
14例年龄在38至82岁（平均57岁）的患者的15只眼睛因眼内肿瘤接受了二极管激光经瞳孔温热疗法治疗。13例患者被诊断为原发性眼内肿瘤，1例有转移；13例肿瘤单侧定位，1例双眼出现肿瘤。随访期（从治疗开始）为1至3个月。
所有患者均使用IRIS Medical instruments公司的二极管激光OcuLight SLx进行经瞳孔温热疗法（TTT）。激光光斑的功率和大小取决于肿瘤大小和色素沉着。治疗所用平均功率为600 mW，平均照射时间为1分钟。
总共15只接受治疗的眼睛中，8例肿瘤消退，6例稳定，1例进展。关于并发症和副作用，治疗期间发现治疗区域出现视野暗点以及视力下降。2例患者视力有轻微改善。
在某些选定病例中，经瞳孔温热疗法（TTT）可能有效，尤其是对于小肿瘤（高度达4.5 mm）。未来它可能会成为唯一的治疗方法。较大肿瘤（高度超过4.5 mm）的治疗应联合使用钌板（106Ru）。治疗过程中发现的所有并发症和副作用对眼睛无危险（少量出血），患者相对容易耐受。随着对更多患者进行更长时间的随访，可能会确定这种治疗的最佳参数、优势以及可能的其他并发症。
