Br J Ophthalmol. 2014 Apr;98(4):494-7. doi: 10.1136/bjophthalmol-2013-304432. Epub 2014 Jan 23.
To report on the use of multi-dose photodynamic therapy (PDT) in the treatment of posterior uveal melanoma.
Prospective case series. 18 patients with posterior uveal melanoma were treated with a minimum of three sessions of PDT. Mean tumour thickness was 1.92 mm (median 1.75, range 0.5-4.4 mm) while the mean basal diameter was 7.1 mm (median 6.3, range 5.2-11 mm). Patients were assessed for visual acuity, complications, tumour status and systemic metastases.
In 16 cases, the tumour regressed with stable or improved vision in 15 patients (83%) over a mean follow-up period of 28 months (median 26.5, range 12-44 months). One patient developed an edge recurrence on two occasions ultimately requiring proton beam therapy while one patient showed no response to PDT before being successfully treated with proton beam therapy. Two patients developed scleritis requiring a short course of systemic steroids. No patient developed metastatic disease in the study period.
Posterior uveal melanomas may be successfully treated with high dose PDT with retention of good vision in the majority of cases, at least in the short-term. Longer follow-up is required to see if these encouraging results are maintained.
报告多剂量光动力疗法（PDT）在治疗脉络膜黑色素瘤中的应用。
前瞻性病例系列研究。18 例脉络膜黑色素瘤患者接受了至少三次 PDT 治疗。平均肿瘤厚度为 1.92mm（中位数 1.75mm，范围 0.5-4.4mm），平均基底直径为 7.1mm（中位数 6.3mm，范围 5.2-11mm）。对患者的视力、并发症、肿瘤状况和全身转移情况进行评估。
在 16 例患者中，肿瘤退缩，15 例患者（83%）视力稳定或改善，平均随访时间为 28 个月（中位数 26.5 个月，范围 12-44 个月）。1 例患者出现 2 次边缘复发，最终需要质子束治疗，1 例患者在接受质子束治疗前对 PDT 无反应。2 例患者发生巩膜炎，需要短期全身皮质类固醇治疗。在研究期间，没有患者发生转移性疾病。
对于大多数病例，高剂量 PDT 可成功治疗脉络膜黑色素瘤，保留良好的视力，至少在短期内是如此。需要更长时间的随访，以观察这些令人鼓舞的结果是否得以维持。
