I read with interest the recent article by Oosterhuis et al1 on transpupillary thermotherapy. It would be interesting to know exactly what the authors mean by "responded insufficiently" or "when regression of the melanoma height . . . after 106 Ru plaque treatment was insufficient,"1 to assess the efficacy of transpupillary thermotherapy as secondary treatment to radioactive plaque therapy. This omitted information is relevant, because if the authors consider the absence of complete flattening as an insufficient response, they may have included cases with partial tumor shrinkage, which involves tumor inviability,2,3 and these lesions could have undergone further shrinkage and even complete flattening over time and thus would not need transpupillary thermotherapy. If, on the other hand, they consider the ongoing tumor growth equivalent to insufficient response, the results of this article would support the efficacy of transpupillary thermotherapy in local control of choroidal melanoma after plaque failure, thus avoiding secondary enucleation.
Valverde-Almohalla S. Transpupillary Thermotherapy in 50 Patients With Choroidal Melanoma. Arch Ophthalmol. 1998;116(12):1697. doi: