Transpupillary thermotherapy as primary treatment for small choroidal melanomas.

PURPOSE

To report short-term follow-up of eyes containing small choroidal melanomas that were treated with transpupillary thermotherapy (TTT).

METHODS

Twenty eyes with suspected small choroidal melanomas were treated with TTT using infrared light delivered from the diode laser.

RESULTS

The age of patients ranged from 26 to 82 years. In 14, there was documented growth of the melanoma prior to TTT. Tumor thicknesses ranged from less than 1 to 3.2 mm. Seven tumors were treated more than once. Follow-up ranged from 6 months to more than 3 years. Following treatment, tumor thicknesses decreased in all cases, usually within 2 months. Progressive atrophy of tumor mass and loss of pigmentation within the tumor continued beyond 1 year of follow-up in some eyes. Complications included field defects, vascular changes, and macular abnormalities.

CONCLUSIONS

Transpupillary thermotherapy of small choroidal melanomas is usually followed by early tumor shrinkage but is complicated by dense scotomas, nerve fiber bundle defects, and occasionally macular abnormalities. Short-term follow-up suggests that TTT may arrest growth of selected small melanomas.