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Long‐term outcome of transpupillary thermotherapy as primary treatment of selected choroidal melanoma
Author(s) -
Parrozzani Raffaele,
Boccassini Barbara,
De Belvis Valentina,
Radin Pietro Paolo,
Midena Edoardo
Publication year - 2009
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2008.01327.x
Subject(s) - medicine , surgery , choroid , ophthalmology , radiation therapy , sclera , brachytherapy , retina , physics , optics
. 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.