Primary Transpupillary Thermotherapy of Choroidal Melanoma

Kreusel K.-M., Bechrakis N. E., Riese J., Foerster M. H.,
Freie Universität Berlin, Klinikum Benjamin Franklin, Augenklinik (Berlin)

Purpose: Transpupillary Thermotherapy (TTT) is a new method which can be used in addition to common treatment procedures of malign choroidal melanoma (CM) as well as a primary therapy for small posterior CM.
Method: The outcome of a consecutive series of 50 CM treated by TTT was prospectively studied. TTT was performed by means of a commercial 810 nm laser (Iris medical, USA) as an outpatient procedure in retrobulbar anesthesia. Regression of the tumor, final visual acuity and number and kind of complications after treatment were evaluated. Follow-up was 15 (3-31) months, tumor thickness and visual acuity before treatment were 2.3±0.6 mm and 0.65±0.28, respectively.
Results: After a mean of 2(1-4) treatments mean remaining tumor thickness was 67 (0-125) % of initial thickness. Mean loss of visual acuity was one line. Complications of TTT were: macular pucker (n=4), retinal detachment (n=2), tumor relapse or lack of regression with necessity of a second therapy (n=3).
Conclusions: TTT is a simple and effective procedure for the treatment of small posterior choroidal melanoma. The rate of early complications is low. For evaluation of late complications or tumor recurrencies however, a longer follow-up is required.

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