Primary transpupillary thermotherapy for small choroidal melanomas

Area of Science:

• Ophthalmology
• Oncology
• Medical Physics

Background:

• Choroidal melanomas are the most common primary intraocular malignancy.
• Transpupillary thermotherapy (TTT) is a non-invasive treatment modality for choroidal melanomas.
• Assessing the efficacy and recurrence rates of TTT is crucial for patient management.

Purpose of the Study:

• To evaluate the visual and anatomical outcomes of transpupillary thermotherapy (TTT) as a primary treatment for small choroidal melanomas.
• To determine the recurrence rates and long-term control associated with TTT.

Main Methods:

• Retrospective review of 20 patients with small choroidal melanomas treated with primary TTT.
• Inclusion criteria: tumors posterior to the equator, <12 mm basal diameter, <3.5 mm thickness, with documented growth or risk factors.
• Follow-up included visual acuity, tumor thickness, and recurrence assessment.

Main Results:

• Tumor regression without recurrence was achieved in 55% of cases after a mean of 2.15 TTT sessions.
• Recurrence occurred in 45% of patients, with successful retreatment in 5 out of 9 cases.
• Mean follow-up was 44.6 months; no tumor-related metastasis or death was observed.

Conclusions:

• Transpupillary thermotherapy (TTT) for small choroidal melanomas is associated with significant recurrence rates.
• While initial tumor control may be achieved, long-term surveillance is necessary.
• Repeat TTT or alternative therapies may be required to manage recurrences effectively.