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Primary photodynamic therapy of choroidal melanoma
Author(s) -
HEIMANN H,
COUPLAND SE,
DAMATO B
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.1755-3768.2009.4167.x
Subject(s) - medicine , melanoma , visual acuity , choroid , photodynamic therapy , radiation therapy , choroidal melanoma , enucleation , ophthalmology , monosomy , surgery , radiology , retina , chemistry , physics , organic chemistry , cancer research , optics , biochemistry , karyotype , gene , chromosome
Abstract Purpose To review our initial experience with photodynamic therapy of choroidal melanoma at the Ocular Oncology Service in Liverpool. Methods Patients were included in the study if they underwent primary photodynamic therapy for choroidal melanoma. The treatment was administered using the same protocol as for choroidal neovascularization. Results The patients (12 male and 5 female) had a mean age of 62.2 years. The melanomas were located in the right eye in 11 patients and the left eye in 6 patients. The tumour margin extended anteriorly to pre‐equatorial choroid in one patient and posteriorly to include optic disc in 7 patients. The melanomas had a mean diameter of 7.6 mm and a mean thickness of 2.0mm. The initial visual acuity was 6/12 or better in 13 patients and 6/18‐6/60 in 4 patients. Biopsy showed the tumour to be of spindle cell type in two patients and to contain epithelioid cells in three patients. One patient was found to have monosomy 3 so that the tumour was treated with proton beam radiotherapy. The follow‐up ranged to 622 days with a median of 101 days. Four patients subsequently underwent proton beam radiotherapy and one patient was treated by endoresection. The last known visual acuity was 6/12 or better in 11 patients, 6/18 to 6/60 in 4 patients and 3/60 to Counting Fingers in 2 patients. Conclusion Photodynamic therapy may be worth attempting in patients with a small choroidal melanoma when other methods are likely to cause visual loss. Many patients subsequently require more aggressive treatment to achieve local tumour control.