Long-term outcome of transpupillary thermotherapy as primary treatment of selected choroidal melanoma

Raffaele Parrozzani, Barbara Boccassini, Valentina De Belvis, Pietro Paolo Radin, Edoardo Midena

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To evaluate prospectively, on a long-term range, the clinical outcomes of transpupillary thermotherapy (TTT) as primary treatment of selected choroidal melanoma. Methods: Seventy-seven eyes of 77 patients affected by small posterior choroidal melanoma were treated with TTT as a sole treatment, using an infrared diode laser at 810 nm according to a standard procedure. Follow-up was longer than 36 months. Results: Seventeen tumours (22%) were parapapillary (PP) and 60 tumours (78%) were non-parapapillary (NPP) in location. Mean follow-up was 55.2 ± 17.9 months in PP tumours and 44.3 ± 23.7 months in NPP tumours. Thirteen (76%) PP tumours and 55 (92%) NPP tumours regressed (P > 0.05). Nine tumours recurred: seven were retreated using Iodine-125 brachytherapy and two were enucleated (both parapapillary). Four patients (5%) developed liver metastasis and died during follow-up. Tumour thickness was found to be predictive of recurrence (odds ratio: 4.3). Complications were found in 20 eyes (26%): macular pucker in 11 (14%), macular oedema in three (4%), retinal vein occlusion in six (8%), vitreous and subretinal haemorrhage in two (3%) and neovascular glaucoma in three (4%). PP tumours had more local complications (but this was not statistically significant; P > 0.05). Complications appeared more frequently in tumours treated with more than one TTT session (P = 0.01), and time-risk to develop intraocular complications seems longer in the PP group, without reaching statistical significance (P = 0.07). Conclusion: TTT may be a clinically effective method for conservative treatment of selected, non-parapapillary, small posterior choroidal melanoma.

Original languageEnglish
Pages (from-to)789-792
Number of pages4
JournalActa Ophthalmologica
Volume87
Issue number7
DOIs
Publication statusPublished - 2009

Keywords

  • Choroidal melanoma
  • Complications
  • Conservative treatment
  • Hyperthermia
  • Infrared light
  • Long-term outcome
  • Necrosis
  • Transpupillary thermotherapy

ASJC Scopus subject areas

  • Ophthalmology
  • Medicine(all)

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