Transpupillary thermotherapy as primary treatment for small choroidal melanomas

Objective: To report the short-term follow-up results of eves containing sm all choroidal melanomas that were treated with transpupillary thermotherapy . Methods: Twenty eves with suspected small choroidal melanomas were treated with transpupillary thermotherapy using infrared light delivered from the d iode laser. Results: The age of the patients ranged from 26 to 82 years. In 14 patients , there was documented growth of the melanoma before transpupillary thermot herapy. The tumor thickness ranged from less than 1.0 to 3.2 mm. Seven tumo rs were treated more than once. Follow-up ranged from 6 months to more than 3 years. Following treatment, the tumor thickness decreased in ail cases, usually within 2 months. Progressive atrophy of tumor mass and loss of pigm entation within the tumor continued beyond 1 year of follow-up in some eyes . Complications included field defects, vascular changes, and macular abnor malities. Conclusions: Transpupillary thermotherapy of small choroidal melanomas is u sually followed by early tumor shrinkage but is complicated by dense scotom as, nerve fiber bundle defects, and, occasionally, macular abnormalities. T he short-term follow-up results suggest that transpupillary thermotherapy m ay arrest the growth of selected small melanomas.