LASER PHOTOCOAGULATION TREATMENT OF CHOROIDAL MELANOMA

Ten cases of choroidal melanoma were treated with Argon and/or Krypton laser photocoagulation in this retrospective study. Each patient rece ived an average of 9.6 laser treatment sessions. Three female and seve n male patients were treated and followed for an average of 69.9 month s. Clinical regression was observed in seven cases (70%). Tumour size in these successfully treated cases ranged from 4.5 x 5.0 x 1.5 mm to 7.0 x 7.0 x 3.5 mm. Continued growth occurred in one case (10%), tumou r recurrence which failed to respond to additional laser treatment in another (10%), and although a recurrence appeared to respond to additi onal laser in a third case (the largest tumour in the series 11.0 x 9. 0 x 2.5 mm) extraocular extension was found at enucleation (10%). Comp lications of laser treatment included cystoid macular oedema (Case 5), branch retinal vein occlusion (Cases 3 and 6), vitreous haemorrhage f rom neovascularisation at the edge of the scar, optic atrophy and thro mbotic glaucoma (Case 8), and macular involvement by laser (Cases 4, 7 and 10). All patients remain alive without any clinical evidence of m etastatic disease at the end of the follow-up period. These results su ggest that laser photocoagulation treatment is a useful option in the management of small choroidal melanomas. It avoids the psychological t rauma of enucleation, and maintains some vision, without compromising life expectancy.