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.

Abstract

Insights

Transpupillary thermotherapy (TTT) effectively shrinks small choroidal melanomas, but can cause vision complications. Short-term results suggest TTT may halt growth in select cases.

Area of Science:

  • Ophthalmology
  • Oncology

Background:

  • Choroidal melanomas are the most common primary intraocular tumors.
  • Small melanomas require effective and safe treatment options.

Observation:

  • Twenty eyes with small choroidal melanomas underwent transpupillary thermotherapy (TTT).
  • Tumor thicknesses ranged from less than 1 to 3.2 mm.
  • Follow-up extended from 6 months to over 3 years.

Findings:

  • TTT treatment resulted in decreased tumor thickness in all cases, typically within 2 months.
  • Progressive tumor atrophy and depigmentation were observed beyond one year in some patients.
  • Complications included visual field defects, vascular changes, and macular abnormalities.

Implications:

  • TTT is a viable option for small choroidal melanomas, often leading to early tumor shrinkage.
  • Potential complications necessitate careful patient selection and monitoring.
  • Short-term data indicate TTT may arrest the growth of selected small melanomas.

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