What is the capability of transpupillary thermotherapy (TTT) in the treatment of flat choroidal melanomas at the posterior pole? A survey of the current literature

Backround Transpupillary thermotherapy is a relatively new method far the t reatment of choroidal melanomas. We present a systematic survey of the curr ent literature. Method A temperature rise in the tumor ranging from 45-60 degrees C is achi eved by an infrared laser beam delivered through the dilated pupil. With a modified delivery system beam widths between 1 and 3 mm and exposure times of one minute are generated. Thus, tumors of up to 4 mm thickness are treat able. TTT can be used as a single treatment procedure or in combination wit h brachytherapy. Results: Several studies presented in the literature show a satisfactory local tumor control. However, there is a significant risk of vision threatening side effects like retinal vascular occlusion or retinal traction in selected cases. Conclusion The TTT is a minimal invasive procedure for the treatment of fla t choroidal melanomas of the posterior pole which is capable of achieving a good local tumor control. Studies with more patients and longer follow-up will demonstrate if TTT is also beneficial in the longterm management of ch oroidal melanomas.