Transpupillary Thermotherapy in the Management of Intraocular Tumors

Purpose: To evaluate the effectiveness of transpupillary thermotherapy (TTT) (diod laser 810 nm) in clinically diagnosed cases of choroidal melanoma, choroidal hemangioma and retinoblastoma. Methods: Between the years 2001-2004, 37 choroidal melanoma cases, 3 choroidal hemangioma cases and 11 retinoblastoma cases have been treated by transpupillary thermotherapy, total 51 cases. Tumor heights in choroidal melanoma cases were ranging between 3-6 mm. and in retinoblastoma cases the tumor thickness was (not more than) 4 mm. Transpupillary thermotherapy has been used as a primary treatment (30 cases) or as secondary treatment (7 cases) for choroidal melanoma and again as primary treatment in 10 cases for retinoblastoma. The energy, required ranged between (250-850 mW). Results: The cases were followed up 4 months at least and 3 years at most. In five cases of primary treatment group, there was no tumor response. In 3 of 25 successfully treated cases there was a focal tumor recurrance, in 3 cases vitreous hemorrhage, and neovascular glaucoma in one case, were the most significant complications of TTT that occured during the follow up. Complete tumor regression was achieved in 22 cases after 2 to 5 treatment sessions. During follow up period no metastatic disease was detected. In 7 cases with uveal melanoma who have a suspected tumor control after plaque radiotherapy, treated secondarily with TTT, did not provide a complementary focal tumor atrophy. tn 6 of 10 retinoblastoma cases, who received TTT as a primary treatment method, tumor regression (Type 3 and Type 4) can be achieved, and in 4 cases no tumor response can be obtained. In 3 cases with choroidal hemangioma, in spite of a large tumor base, complete tumor regression can be achived. Conclusion: Intraocular tumors, which are not more than 4 mm. in height, can be treated safely by transpupillary thermotherapy. method alone and during follow-up period, initially successfully treated masses, can cause complications like recurrences and vitreous hemorrhages.