This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (3)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Ocular/ Adnexal Tumors  • Retinal/ Chorioretinal Disorders  • Alert me on articles by topic

Peter H. Win, MD; Dennis M. Robertson, MD; Helmut Buettner, MD; Colin A. McCannel, MD; Steven R. Bennett, MD

Arch Ophthalmol. 2006;124:503-506.

Objective  To report our longer-term follow-up observations in patients with small choroidal melanomas primarily treated with transpupillary thermotherapy (TTT).

Methods  In this noncomparative interventional case series, 40 patients with small melanocytic tumors of the choroid (thickness <3.5 mm) underwent TTT. Follow-up examinations including ophthalmoscopy, ultrasonography, and fundus photography were conducted at 24 to 48 hours, 2 to 6 weeks, and 6-month intervals after treatment.

Results  Forty patients (mean age, 58 years) with small melanocytic tumors underwent TTT. Mean follow-up in all patients was 42 months. In most cases TTT resulted in tumor regression. Thirty-one (77.5%) of 40 tumors did not recur after initial treatment with TTT. In 5 (12.5%) of 40 tumors with initial basal diameters ranging from 4 x 2.75 mm to 7.5 x 6 mm and a mean initial thickness of 2.0 mm, edge recurrences developed, which were satisfactorily treated with additional TTT (4 cases) or cryotherapy (1 case). The mean interval between initial TTT and recurrence in this subgroup was 15 months (range, 7-22 months). Of 36 eyes that were successfully treated with TTT or cryotherapy, 26 eyes (72%) had posttreatment visual acuity better than or equal to pretreatment visual acuity. Four (10%) of 40 tumors were not controlled with TTT and eventually required brachytherapy (n = 1), proton radiation (n = 1), or enucleation (n = 2). The initial basal diameters of these tumors ranged from 7.5 x 7.5 mm to 9 x 7.5 mm, with a mean initial thickness of 2.6 mm. The mean interval between treatment and determination of treatment failure was 22 months (range, 7-30 months).

Conclusions  Transpupillary thermotherapy resulted in tumor regression of most small melanocytic choroidal tumors. Tumor edge recurrences were successfully treated with additional TTT in most cases. Four tumors required irradiation or enucleation because of treatment failures with TTT. Transpupillary thermotherapy as a stand-alone therapy is insufficient for some small choroidal melanomas.

Author Affiliations: Department of Ophthalmology, Mayo Clinic, Rochester, Minn (Drs Win, Robertson, Buettner, and McCannel); VitreoRetinal Surgery, PA, Minneapolis, Minn (Dr Bennett).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Small Choroidal Melanomas Treated With Transpupillary Thermotherapy and Cryotherapy
Robertson
Arch Ophthalmol 2008;126:1156-1157.
FULL TEXT  

Primary transpupillary thermotherapy of "small" choroidal melanoma: is it safe?
Singh et al.
Br. J. Ophthalmol. 2008;92:727-728.
FULL TEXT  

Primary transpupillary thermotherapy for small choroidal melanomas
Pan et al.
Br. J. Ophthalmol. 2008;92:747-750.
ABSTRACT | FULL TEXT  

Long-term results of primary transpupillary thermal therapy for the treatment of choroidal malignant melanoma
Aaberg et al.
Br. J. Ophthalmol. 2008;92:741-746.
ABSTRACT | FULL TEXT