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Results in 50 Patients With Choroidal Melanoma

Jendo A. Oosterhuis, PhD, MD; Hanneke G. Journée-de Korver; Jan E. E. Keunen, PhD, MD

Arch Ophthalmol. 1998;116:157-162.

Objective  To evaluate the efficacy and safety of transpupillary thermotherapy in treating choroidal melanoma.

Methods and Patients  To perform transpupillary thermotherapy, infrared diode laser energy at 810 nm was used with a beam diameter of about 3 mm and 1-minute exposure time. All 50 patients had choroidal melanoma. We performed transpupillary thermotherapy in 21 tumors that had responded insufficiently to 800 Gy ruthenium 106 brachytherapy; it was combined with 800 Gy ¹⁰⁶Ru brachytherapy for 10 tumors greater than 5 mm in height and with 600 Gy for 19 tumors 5 mm or less in height.

Results  All but 1 tumor exhibited reduction in tumor height within a mean follow-up of 20.5 months (range, 6-49 months). In 41 eyes (82%), the tumor flattened completely. Visual acuity was 20/60 or better in 43 eyes (86%) before treatment and in 14 eyes (28%) at the last examination because of radiation vasculopathy. Neovascular glaucoma developed in 1 eye, and total retinal detachment developed in 2 eyes. Tumor recurrence was observed in 1 patient.

Conclusions  Although long-term results are necessary to properly appraise this new therapy, transpupillary thermotherapy may be useful as a complementary modality to brachytherapy.

From the Department of Ophthalmology, Leiden University Medical Center, the Netherlands.

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