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Transpupillary thermotherapy as primary treatment for small choroidal melanomas
D M Robertson1, H Buettner, S R Bennett
1Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA.
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.
