Thermotherapy in the management of choroidal melanoma.
During the past 20 years of enucleation, which was the standard treatment for choroidal melanoma over more than a century, has largely been replaced by eye salvaging therapies such as radiotherapy or local resection. In 1995 transpupillary thermotherapy (TTT) using an infrared diode laser was introduced as a new conservative therapy for patients with choroidal melanoma. TTT can be defined as a heat treatment modality, which is delivered through a dilated pupil to the tumour surface. The technique uses a wide diode laser beam diameter with a low irradiance and a long exposure time. TTT induces tumour necrosis at sub-photocoagulation levels by a direct cell destructive effect with only a few ocular complications. TTT can be performed as sole therapy or combined with plaque radiotherapy, thus permitting a lower radiation dose. For amelanotic tumours dye-enhanced TTT with indocyanine green can be used. In this paper we review the role of sole or combined TTT, related to the current other treatment modalities for choroidal melanoma.
Journée-de Korver
J G
JG
Department of Ophthalmology, Ocular Oncology Service, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, The Netherlands. j.g.journee-de_korver@lumc.nl
Keunen
J E E
JE
D002830:Choroid Neoplasms / Q000628:therapy*; D003972:Diathermy; D006801:Humans; D006979:Hyperthermia, Induced; D008028:Light Coagulation; D008545:Melanoma / Q000628:therapy*; D011680:Pupil