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20 years of enucleation, which was the standard treatment for choroidal melanoma over more than a century, has largely been replaced by eye salvaging therapies such as radiotherapy or local resection.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 introd...

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Bibliographic Details
Published in:Progress in retinal and eye research 2002-05, Vol.21 (3), p.303-317
Main Authors: Journée-de Korver, J.G, Keunen, J.E.E
Format: Article
Language:English
Subjects:
Choroid Neoplasms - therapy
Diathermy
Humans
Hyperthermia, Induced
Light Coagulation
Melanoma - therapy
Pupil
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Summary: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20 years of enucleation, which was the standard treatment for choroidal melanoma over more than a century, has largely been replaced by eye salvaging therapies such as radiotherapy or local resection.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.
ISSN:1350-9462
1873-1635
DOI:10.1016/S1350-9462(02)00005-8