Transpupillary Thermotherapy (TTT) of Malignant Choroidal Melanoma - Follow-up after 14 Months

Feucht M., Fuisting B., Richard G.,
Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Augenheilkunde (Hamburg)

Purpose: For the treatment of small choroidal melanomas (< 3.0 mm) or residual tumors after brachytherapy recently Transpupillary Thermotherapy (TTT) is used increasingly.
Methods: 36 patients with a small primary malignant melanoma (<3.0 mm, 16 patients) or after preceded brachytherapy (20 patients) were treated with Transpupillary Thermotherapy. Infrared diode laser light at 810 nm was used to apply laser spots of about 3000mm. Laserenergy ≥800mW was needed to achieve visible effects after 60 seconds duration. A complete ophthalmologic examination including visual acuity, slit-lamp biomicros-copy, funduscopy, ultrasound and fluorescein angiography was performed prior to and after the treatment.
Results: After 14 months in 24 (66.6%) of the patients a complete occlusion of the treated tumor vessels was observed. In 12 (33,3%) patients a residual tumor activity could be identified in fluorescein angiography. In 14 patients TTT was necessary only one time to get a complete reduction of the tumor, the remaining 22 patients received a repeated TTT-therapy without any problems.
Conclusions: Transpupillary Thermotherapy is proven to be an effective and save therapy for patients with residual tumor or small choroidal melanoma. During the observed period none of the patients required enucleation and only one patient needed an additional brachytherapy.

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