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Clinical Sciences
November 1999

Transpupillary Thermotherapy as Primary Treatment for Small Choroidal Melanomas

Author Affiliations

From the Department of Ophthalmology, Mayo Clinic, Mayo Foundation, and Mayo Medical School, Rochester (Drs Robertson and Buettner), and VitreoRetinal Surgery, P. A., St Paul (Dr Bennett), Minn.

Arch Ophthalmol. 1999;117(11):1512-1519. doi:10.1001/archopht.117.11.1512

Objective  To report the short-term follow-up results of eyes containing small choroidal melanomas that were treated with transpupillary thermotherapy.

Methods  Twenty eyes with suspected small choroidal melanomas were treated with transpupillary thermotherapy using infrared light delivered from the diode 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 thermotherapy. The tumor thickness ranged from less than 1.0 to 3.2 mm. Seven tumors were treated more than once. Follow-up ranged from 6 months to more than 3 years. Following treatment, the tumor thickness decreased in all cases, usually within 2 months. Progressive atrophy of tumor mass and loss of pigmentation within the tumor continued beyond 1 year of follow-up in some eyes. Complications included field defects, vascular changes, and macular abnormalities.

Conclusions  Transpupillary thermotherapy of small choroidal melanomas is usually followed by early tumor shrinkage but is complicated by dense scotomas, nerve fiber bundle defects, and, occasionally, macular abnormalities. The short-term follow-up results suggest that transpupillary thermotherapy may arrest the growth of selected small melanomas.