Transpupillary thermotherapy in choroidal melanomas.

OBJECTIVE

To determine safety and efficacy of transpupillary thermotherapy (TTT) as a new treatment for choroidal melanoma.

METHODS AND PATIENTS

To perform TTT, diode laser energy at 810 nm was used with a beam diameter of 1.5 to 4.5 mm for a 1-minute exposure. All 12 patients had choroidal melanoma. Six had had insufficient response to ruthenium 106 (106Ru) brachytherapy. Three patients with tumors more than 5 mm in height were treated simultaneously with 106Ru and TTT. Three patients with juxtapapillary or macular tumors were treated by TTT only.

RESULTS

All but one tumor exhibited a reduction of tumor height in a follow-up period of 3 to 14 months. Side effects were minimal. Severe visual loss occurred in two patients due to radiation retinopathy, in two patients whose foveas were included in the TTT area, and in one patient resulting from a serous retinal detachment that extended over the posterior pole.

CONCLUSIONS

Treatment with TTT may be useful as a complementary modality to brachytherapy. A longer follow-up period is required for final evaluation.