[Optimization of indications for transpupillary thermotherapy for choroidal melanomas]

The paper analyzes recent literature and the authors' experience in treating choroidal melanoma with transpupillary thermotherapy. Analysis of the results of treatment in 30 patients shows the efficiency of the technique only the tumor is less than 2 mm thick. When the latter is larger, transpupillary thermotherapy may be used only in combination with brachytherapy. Risk factors worsening the efficiency of thermotherapy are defined. These include tumors that are more than 2 mm thick or slightly pigmented, and the presence of a subretinal exudate. The frequency and severity of complications were estimated after transpupillary thermotherapy. The occurrence of complications and their pattern depend on the baseline sizes of choroidal melanoma, the number of performed sessions, and previous treatment (local tumor resolution). Comparison of the data available in the literature and the authors' experience made it possible to define clear indications for transpupillary thermotherapy in order to treat choroidal melanomas and to identify factors promoting the prevention of possible complications.