Oosterhuis J A, Journée-de Korver H G, Kakebeeke-Kemme H M, Bleeker J C
Department of Ophthalmology, Leiden.
Arch Ophthalmol. 1995 Mar;113(3):315-21. doi: 10.1001/archopht.1995.01100030071024.
To determine safety and efficacy of transpupillary thermotherapy (TTT) as a new treatment for choroidal melanoma.
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.
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.
Treatment with TTT may be useful as a complementary modality to brachytherapy. A longer follow-up period is required for final evaluation.
确定经瞳孔温热疗法（TTT）作为脉络膜黑色素瘤新治疗方法的安全性和有效性。
进行TTT时，使用波长810nm的二极管激光能量，光束直径为1.5至4.5mm，曝光1分钟。所有12例患者均患有脉络膜黑色素瘤。6例对钌106（106Ru）近距离放射治疗反应不足。3例肿瘤高度超过5mm的患者同时接受106Ru和TTT治疗。3例视乳头旁或黄斑区肿瘤患者仅接受TTT治疗。
在3至14个月的随访期内，除1个肿瘤外，所有肿瘤的高度均有所降低。副作用最小。2例患者因放射性视网膜病变导致严重视力丧失，2例患者的黄斑中心凹包含在TTT治疗区域内，1例患者因浆液性视网膜脱离扩展至后极部。
TTT治疗可作为近距离放射治疗的补充方式。最终评估需要更长的随访期。
