Tranpupillary thermotherapy for mall choroidal melanoma Original Reearch Article

PURPOE: To report the treatment of mall choroidal melanoma with tranpupillary thermotherapy. METHOD: We examined a nonrandomized and uncontrolled erie of 14 eye of 14 patient who were followed up with erial ophthalmocopy, ultraonography, and photography. Tranpupillary thermotherapy wa performed upon documented evidence of tumor growth. REULT: After tranpupillary thermotherapy, mean follow-up ± D wa 16 ± 6.41 month (range, 7 to 28 month) with 10 eye followed up for at leat 1 year. The mean preoperative tumor height wa 1.79 ± 0.59 mm (range, 0.78 to 2.60 mm). ix month after treatment, the mean height wa 0.54 mm ± 0.57 mm (range, 0.00 to 1.16 mm). In 10 eye, the treated leion flattened entirely with a mean interval between treatment and flattening of 8.7 month (range, 3 to 21 month). Three patient required retreatment for lack of regreion or recurrent growth. The average time to retreatment wa 11 month (range, 5 to 15 month). No eye wa retreated more than once. There were three amelanotic leion, all treated in a ingle eion without recurrence. Complication conited of retinal hemorrhage, retinal vacular occluion, retinal traction, exudative erou neuroenory detachment, vitreiti, and potoperative pain. The ole treatment failure occurred in an eye treated with a juxtapapillary tumor, with recurrence developing from a previouly flattened leion. Thi eye wa enucleated 10 month after the ingle initial treatment. At the time of writing, there had been no tumor-related death. CONCLUION: Tranpupillary thermotherapy may repreent a viable treatment alternative for both pigmented and amelanotic mall choroidal melanoma. Diligent follow-up i axiomatic becaue retreatment may be neceary. Recurrent tumor may develop from flat leion. Juxtapapillary tumor may be at higher rik for recurrence. Definitive tatement regarding the role of tranpupillary thermotherapy in the management of mall choroidal melanoma await 5-year and 10-year morbidity and mortality data.