Acta Ophthalmol. 2009 Nov;87(7):789-92. Epub 2008 Sep 5. Long-term outcome of transpupillary thermotherapy as primary treatment of selected choroidal melanoma. Parrozzani R, Boccassini B, De Belvis V, Radin PP, Midena E. SourceDepartment of Ophthalmology, University of Padova, Italy. Abstract PURPOSE: To evaluate prospectively, on a long-term range, the clinical outcomes of transpupillary thermotherapy (TTT) as primary treatment of selected choroidal melanoma. METHODS: Seventy-seven eyes of 77 patients affected by small posterior choroidal melanoma were treated with TTT as a sole treatment, using an infrared diode laser at 810 nm according to a standard procedure. Follow-up was longer than 36 months. RESULTS: Seventeen tumours (22%) were parapapillary (PP) and 60 tumours (78%) were non-parapapillary (NPP) in location. Mean follow-up was 55.2 ± 17.9 months in PP tumours and 44.3 ± 23.7 months in NPP tumours. Thirteen (76%) PP tumours and 55 (92%) NPP tumours regressed (P > 0.05). Nine tumours recurred: seven were retreated using Iodine-125 brachytherapy and two were enucleated (both parapapillary). Four patients (5%) developed liver metastasis and died during follow-up. Tumour thickness was found to be predictive of recurrence (odds ratio: 4.3). Complications were found in 20 eyes (26%): macular pucker in 11 (14%), macular oedema in three (4%), retinal vein occlusion in six (8%), vitreous and subretinal haemorrhage in two (3%) and neovascular glaucoma in three (4%). PP tumours had more local complications (but this was not statistically significant; P > 0.05). Complications appeared more frequently in tumours treated with more than one TTT session (P = 0.01), and time-risk to develop intraocular complications seems longer in the PP group, without reaching statistical significance (P = 0.07). CONCLUSION: TTT may be a clinically effective method for conservative treatment of selected, non-parapapillary, small posterior choroidal melanoma. PMID: 18778335 [PubMed - indexed for MEDLINE
Long-term outcome of transpupillary thermotherapy as primary treatment of selected choroidal melanoma
PARROZZANI, RAFFAELE;MIDENA, EDOARDO
2009
Abstract
Acta Ophthalmol. 2009 Nov;87(7):789-92. Epub 2008 Sep 5. Long-term outcome of transpupillary thermotherapy as primary treatment of selected choroidal melanoma. Parrozzani R, Boccassini B, De Belvis V, Radin PP, Midena E. SourceDepartment of Ophthalmology, University of Padova, Italy. Abstract PURPOSE: To evaluate prospectively, on a long-term range, the clinical outcomes of transpupillary thermotherapy (TTT) as primary treatment of selected choroidal melanoma. METHODS: Seventy-seven eyes of 77 patients affected by small posterior choroidal melanoma were treated with TTT as a sole treatment, using an infrared diode laser at 810 nm according to a standard procedure. Follow-up was longer than 36 months. RESULTS: Seventeen tumours (22%) were parapapillary (PP) and 60 tumours (78%) were non-parapapillary (NPP) in location. Mean follow-up was 55.2 ± 17.9 months in PP tumours and 44.3 ± 23.7 months in NPP tumours. Thirteen (76%) PP tumours and 55 (92%) NPP tumours regressed (P > 0.05). Nine tumours recurred: seven were retreated using Iodine-125 brachytherapy and two were enucleated (both parapapillary). Four patients (5%) developed liver metastasis and died during follow-up. Tumour thickness was found to be predictive of recurrence (odds ratio: 4.3). Complications were found in 20 eyes (26%): macular pucker in 11 (14%), macular oedema in three (4%), retinal vein occlusion in six (8%), vitreous and subretinal haemorrhage in two (3%) and neovascular glaucoma in three (4%). PP tumours had more local complications (but this was not statistically significant; P > 0.05). Complications appeared more frequently in tumours treated with more than one TTT session (P = 0.01), and time-risk to develop intraocular complications seems longer in the PP group, without reaching statistical significance (P = 0.07). CONCLUSION: TTT may be a clinically effective method for conservative treatment of selected, non-parapapillary, small posterior choroidal melanoma. PMID: 18778335 [PubMed - indexed for MEDLINEPubblicazioni consigliate
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