TRANSPUPILLARY THERMOTHERAPY IN CHOROIDAL MELANOMAS

Objective: To determine safety and efficacy of transpupillary thermoth erapy (TTT) as a new treatment for choroidal melanoma. Methods and Pat ients: To perform TTT, diode laser energy at 810 nm was used with a be am diameter of 1.5 to 4.5 mm for a 1-minute exposure. All 12 patients had choroidal melanoma. Six had had insufficient response to ruthenium 106 ((106)RU) brachytherapy. Three patients with tumors more than 5 m m in height were treated simultaneously with (106)RU and TTT. Three pa tients with juxtapapillary or macular tumors were treated by TTT only. Results: All but one tumor exhibited a reduction of tumor height in a follow-up period of 3 to 14 months. Side effects were minimal. Severe visual loss occurred in two patients due to radiation retinopathy, in two patients whose foveas were included in the TTT area, and in one p atient resulting from a serous retinal detachment that extended over t he posterior pole. Conclusions: Treatment with TTT may be useful as a complementary modality to brachytherapy. A longer follow-up period is required for final evaluation.