Choroidal vascular changes after transpupillary thermotherapy for choroidal melanoma.
OBJECTIVE
To evaluate choroidal vascular alterations after transpupillary thermotherapy used as the sole treatment for choroidal melanoma.


METHODS
Prospective noncomparative interventional case series.


METHODS
Forty-five eyes of 45 patients affected by malignant choroidal melanoma treated with transpupillary thermotherapy alone with more than 1 year of follow-up.


METHODS
Transpupillary thermotherapy was performed through a panfunduscopic contact lens using an 810-nm diode laser.


METHODS
Dynamic/static fluorescein and indocyanine green angiography were performed at scheduled intervals (24 hours, at 3-month intervals during the first year, and every 6 months thereafter) after transpupillary thermotherapy. Visual acuity, clinical evaluation, fundus photographs, and ultrasonographic examination were also performed.


RESULTS
The mean follow-up was 30.5 months (range, 12-54 months). Changes in the choroidal circulation were always confined within the treatment margins (except in one case) and characterized by occlusion of choriocapillaris (100%), patent medium and/or large choroidal vessels (76%), retinochoroidal anastomosis (11%), and progressive choroidal vascular remodeling (42%). Forty-one cases (91%) showed persistent clinical regression, and four cases (9%) recurred; recurrent cases showed retinochoroidal anastomosis.


CONCLUSIONS
Transpupillary thermotherapy is suggested as a new single therapeutic modality in the treatment of selected choroidal melanomas, but more precise eligibility criteria and longer follow-up are mandatory. Patent choroidal circulation, choroidal vascular remodeling, and anastomosis after transpupillary thermotherapy might be helpful to detect recurrent tumors.
Department of Ophthalmology, University of Padova, Padova, Italy. edoardo.midena@unipd.it
Edoardo
E
Midena
Elisabetta
E
Pilotto
Valentina
V
de Belvis
Silvia
S
Zaltron
Daniele
D
Doro
Tatiana
T
Segato
Stefano
S
Piermarocchi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000098:blood supply*; D002830:Choroid Neoplasms / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D007208:Indocyanine Green; D008297:Male; D008545:Melanoma / Q000503:physiopathology* / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D012039:Regional Blood Flow; D014792:Visual Acuity
D007208:Indocyanine Green