Transpupillary Thermotherapy in the Management of Choroidal Melanoma
Background: Several methods of treatment have been used for Choroidal melanoma. The purpose of this report is to evaluate the effectiveness of transpupillary thermotherapy using near-infrared radiation to treat Choroidal melanoma. Methods: A prospective study was conducted to evaluate the clinical f...
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| Veröffentlicht in: | Ophthalmology (Rochester, Minn.) Minn.), 1996-10, Vol.103 (10), p.1642-1650 |
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| creator | Shields, Carol L. Shields, Jerry A. De Potter, Patrick Kheterpal, Sundeep |
| description | Background: Several methods of treatment have been used for Choroidal melanoma. The purpose of this report is to evaluate the effectiveness of transpupillary thermotherapy using near-infrared radiation to treat Choroidal melanoma.
Methods: A prospective study was conducted to evaluate the clinical features, treatment results, and complications of patients with Choroidal melanoma who were treated with transpupillary thermotherapy delivered over one to four sessions and followed for at least a 6-month period. All treated tumors had either documentation of growth or ophthalmoscopic risk factors for future growth andlor metastasis.
Results: There were 17 patients with Choroidal melanoma treated with transpupillary thermotherapy. The mean tumor size before treatment was 6.6 mm in base and 3.0 mm in thickness. The tumor margin was a mean of 2.3 mm from the optic disc and 2.7 mm from the foveola. Seven tumors (41 %)touched the optic disc margin and three (18%) were under the fovea. The tumor responded to treatment in all patients, with a decrease in thickness and resolution of associated subretinal fluid. At a minimum of 6 months of follow-up, the mean tumor thickness was 1.7 mm, and the tumor site was a residual chorioretinal scar with partial visibility of the sclera in all patients. Despite the proximity to the optic disc and foveola, the final visual acuity was the same or improved in ten eyes (59%) and decreased in seven (41 %). The improved vision was due to resolution of subfoveal fluid, whereas the decreased vision was primarily the result of treatment in the fovea with ultimate retinal vascular occlusion or preretinal traction. Although longterm follow-up is not yet available, there were no patients with tumor recurrence or tumor metastases.
Conclusions: This preliminary study demonstrates that transpupillary thermotherapy appears to be an effective treatment for selected small Choroidal melanomas and may be a particularly useful modality for treating those tumors near the foveola and optic disc. Longer follow-up is necessary to assess for local recurrence and the impact of treatment on survival. |
| doi_str_mv | 10.1016/S0161-6420(96)30451-X |
| format | Article |
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Methods: A prospective study was conducted to evaluate the clinical features, treatment results, and complications of patients with Choroidal melanoma who were treated with transpupillary thermotherapy delivered over one to four sessions and followed for at least a 6-month period. All treated tumors had either documentation of growth or ophthalmoscopic risk factors for future growth andlor metastasis.
Results: There were 17 patients with Choroidal melanoma treated with transpupillary thermotherapy. The mean tumor size before treatment was 6.6 mm in base and 3.0 mm in thickness. The tumor margin was a mean of 2.3 mm from the optic disc and 2.7 mm from the foveola. Seven tumors (41 %)touched the optic disc margin and three (18%) were under the fovea. The tumor responded to treatment in all patients, with a decrease in thickness and resolution of associated subretinal fluid. At a minimum of 6 months of follow-up, the mean tumor thickness was 1.7 mm, and the tumor site was a residual chorioretinal scar with partial visibility of the sclera in all patients. Despite the proximity to the optic disc and foveola, the final visual acuity was the same or improved in ten eyes (59%) and decreased in seven (41 %). The improved vision was due to resolution of subfoveal fluid, whereas the decreased vision was primarily the result of treatment in the fovea with ultimate retinal vascular occlusion or preretinal traction. Although longterm follow-up is not yet available, there were no patients with tumor recurrence or tumor metastases.
Conclusions: This preliminary study demonstrates that transpupillary thermotherapy appears to be an effective treatment for selected small Choroidal melanomas and may be a particularly useful modality for treating those tumors near the foveola and optic disc. Longer follow-up is necessary to assess for local recurrence and the impact of treatment on survival.</description><identifier>ISSN: 0161-6420</identifier><identifier>EISSN: 1549-4713</identifier><identifier>DOI: 10.1016/S0161-6420(96)30451-X</identifier><identifier>PMID: 8874438</identifier><identifier>CODEN: OPHTDG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Choroid Neoplasms - diagnostic imaging ; Choroid Neoplasms - pathology ; Choroid Neoplasms - therapy ; Diseases of the eye ; Female ; Follow-Up Studies ; Fundus Oculi ; Humans ; Hyperthermia, Induced ; Infrared Rays ; Male ; Medical sciences ; Melanoma - diagnostic imaging ; Melanoma - pathology ; Melanoma - therapy ; Middle Aged ; Postoperative Complications ; Prospective Studies ; Pupil ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Treatment Outcome ; Ultrasonography ; Visual Acuity</subject><ispartof>Ophthalmology (Rochester, Minn.), 1996-10, Vol.103 (10), p.1642-1650</ispartof><rights>1996 American Academy of Ophthalmology, Inc</rights><rights>1997 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-86659620093c06d35935a2c6cc10de2dd3f942b1ed20f7f231541a95a06139653</citedby><cites>FETCH-LOGICAL-c389t-86659620093c06d35935a2c6cc10de2dd3f942b1ed20f7f231541a95a06139653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S016164209630451X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2471169$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8874438$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shields, Carol L.</creatorcontrib><creatorcontrib>Shields, Jerry A.</creatorcontrib><creatorcontrib>De Potter, Patrick</creatorcontrib><creatorcontrib>Kheterpal, Sundeep</creatorcontrib><title>Transpupillary Thermotherapy in the Management of Choroidal Melanoma</title><title>Ophthalmology (Rochester, Minn.)</title><addtitle>Ophthalmology</addtitle><description>Background: Several methods of treatment have been used for Choroidal melanoma. The purpose of this report is to evaluate the effectiveness of transpupillary thermotherapy using near-infrared radiation to treat Choroidal melanoma.
Methods: A prospective study was conducted to evaluate the clinical features, treatment results, and complications of patients with Choroidal melanoma who were treated with transpupillary thermotherapy delivered over one to four sessions and followed for at least a 6-month period. All treated tumors had either documentation of growth or ophthalmoscopic risk factors for future growth andlor metastasis.
Results: There were 17 patients with Choroidal melanoma treated with transpupillary thermotherapy. The mean tumor size before treatment was 6.6 mm in base and 3.0 mm in thickness. The tumor margin was a mean of 2.3 mm from the optic disc and 2.7 mm from the foveola. Seven tumors (41 %)touched the optic disc margin and three (18%) were under the fovea. The tumor responded to treatment in all patients, with a decrease in thickness and resolution of associated subretinal fluid. At a minimum of 6 months of follow-up, the mean tumor thickness was 1.7 mm, and the tumor site was a residual chorioretinal scar with partial visibility of the sclera in all patients. Despite the proximity to the optic disc and foveola, the final visual acuity was the same or improved in ten eyes (59%) and decreased in seven (41 %). The improved vision was due to resolution of subfoveal fluid, whereas the decreased vision was primarily the result of treatment in the fovea with ultimate retinal vascular occlusion or preretinal traction. Although longterm follow-up is not yet available, there were no patients with tumor recurrence or tumor metastases.
Conclusions: This preliminary study demonstrates that transpupillary thermotherapy appears to be an effective treatment for selected small Choroidal melanomas and may be a particularly useful modality for treating those tumors near the foveola and optic disc. Longer follow-up is necessary to assess for local recurrence and the impact of treatment on survival.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Choroid Neoplasms - diagnostic imaging</subject><subject>Choroid Neoplasms - pathology</subject><subject>Choroid Neoplasms - therapy</subject><subject>Diseases of the eye</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundus Oculi</subject><subject>Humans</subject><subject>Hyperthermia, Induced</subject><subject>Infrared Rays</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Melanoma - diagnostic imaging</subject><subject>Melanoma - pathology</subject><subject>Melanoma - therapy</subject><subject>Middle Aged</subject><subject>Postoperative Complications</subject><subject>Prospective Studies</subject><subject>Pupil</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Treatment Outcome</subject><subject>Ultrasonography</subject><subject>Visual Acuity</subject><issn>0161-6420</issn><issn>1549-4713</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEtLAzEQgIMotVZ_grAHET2s5rXZzUmkPqHiwQq9hZjMamR3syZbof_eaEuvXmYC801m5kPomOALgom4fEmB5IJTfCbFOcO8IPliB41JwWXOS8J20XiL7KODGD8xxkIwPkKjqio5Z9UY3cyD7mK_7F3T6LDK5h8QWj-kqPtV5rosPbMn3el3aKEbMl9n0w8fvLO6yZ6g0Z1v9SHaq3UT4WiTJ-j17nY-fchnz_eP0-tZblglh7wSopCCYiyZwcKyQrJCUyOMIdgCtZbVktM3ApbiuqwpS6cQLQuNBWFSFGyCTtf_9sF_LSEOqnXRQNq8A7-Mqqw4r6gsE1isQRN8jAFq1QfXpvsUwerXnvqzp37VKCnUnz21SH3HmwHLtxbstmujK9VPNnUdjW7q5M64uMVo0k6ETNjVGoMk49tBUNE46AxYF8AMynr3zyI_m02Kpg</recordid><startdate>19961001</startdate><enddate>19961001</enddate><creator>Shields, Carol L.</creator><creator>Shields, Jerry A.</creator><creator>De Potter, Patrick</creator><creator>Kheterpal, Sundeep</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19961001</creationdate><title>Transpupillary Thermotherapy in the Management of Choroidal Melanoma</title><author>Shields, Carol L. ; Shields, Jerry A. ; De Potter, Patrick ; Kheterpal, Sundeep</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-86659620093c06d35935a2c6cc10de2dd3f942b1ed20f7f231541a95a06139653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Choroid Neoplasms - diagnostic imaging</topic><topic>Choroid Neoplasms - pathology</topic><topic>Choroid Neoplasms - therapy</topic><topic>Diseases of the eye</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fundus Oculi</topic><topic>Humans</topic><topic>Hyperthermia, Induced</topic><topic>Infrared Rays</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Melanoma - diagnostic imaging</topic><topic>Melanoma - pathology</topic><topic>Melanoma - therapy</topic><topic>Middle Aged</topic><topic>Postoperative Complications</topic><topic>Prospective Studies</topic><topic>Pupil</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Treatment Outcome</topic><topic>Ultrasonography</topic><topic>Visual Acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shields, Carol L.</creatorcontrib><creatorcontrib>Shields, Jerry A.</creatorcontrib><creatorcontrib>De Potter, Patrick</creatorcontrib><creatorcontrib>Kheterpal, Sundeep</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Ophthalmology (Rochester, Minn.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shields, Carol L.</au><au>Shields, Jerry A.</au><au>De Potter, Patrick</au><au>Kheterpal, Sundeep</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transpupillary Thermotherapy in the Management of Choroidal Melanoma</atitle><jtitle>Ophthalmology (Rochester, Minn.)</jtitle><addtitle>Ophthalmology</addtitle><date>1996-10-01</date><risdate>1996</risdate><volume>103</volume><issue>10</issue><spage>1642</spage><epage>1650</epage><pages>1642-1650</pages><issn>0161-6420</issn><eissn>1549-4713</eissn><coden>OPHTDG</coden><abstract>Background: Several methods of treatment have been used for Choroidal melanoma. The purpose of this report is to evaluate the effectiveness of transpupillary thermotherapy using near-infrared radiation to treat Choroidal melanoma.
Methods: A prospective study was conducted to evaluate the clinical features, treatment results, and complications of patients with Choroidal melanoma who were treated with transpupillary thermotherapy delivered over one to four sessions and followed for at least a 6-month period. All treated tumors had either documentation of growth or ophthalmoscopic risk factors for future growth andlor metastasis.
Results: There were 17 patients with Choroidal melanoma treated with transpupillary thermotherapy. The mean tumor size before treatment was 6.6 mm in base and 3.0 mm in thickness. The tumor margin was a mean of 2.3 mm from the optic disc and 2.7 mm from the foveola. Seven tumors (41 %)touched the optic disc margin and three (18%) were under the fovea. The tumor responded to treatment in all patients, with a decrease in thickness and resolution of associated subretinal fluid. At a minimum of 6 months of follow-up, the mean tumor thickness was 1.7 mm, and the tumor site was a residual chorioretinal scar with partial visibility of the sclera in all patients. Despite the proximity to the optic disc and foveola, the final visual acuity was the same or improved in ten eyes (59%) and decreased in seven (41 %). The improved vision was due to resolution of subfoveal fluid, whereas the decreased vision was primarily the result of treatment in the fovea with ultimate retinal vascular occlusion or preretinal traction. Although longterm follow-up is not yet available, there were no patients with tumor recurrence or tumor metastases.
Conclusions: This preliminary study demonstrates that transpupillary thermotherapy appears to be an effective treatment for selected small Choroidal melanomas and may be a particularly useful modality for treating those tumors near the foveola and optic disc. Longer follow-up is necessary to assess for local recurrence and the impact of treatment on survival.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>8874438</pmid><doi>10.1016/S0161-6420(96)30451-X</doi><tpages>9</tpages></addata></record> |
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| ispartof | Ophthalmology (Rochester, Minn.), 1996-10, Vol.103 (10), p.1642-1650 |
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| subjects | Adult Aged Biological and medical sciences Choroid Neoplasms - diagnostic imaging Choroid Neoplasms - pathology Choroid Neoplasms - therapy Diseases of the eye Female Follow-Up Studies Fundus Oculi Humans Hyperthermia, Induced Infrared Rays Male Medical sciences Melanoma - diagnostic imaging Melanoma - pathology Melanoma - therapy Middle Aged Postoperative Complications Prospective Studies Pupil Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Treatment Outcome Ultrasonography Visual Acuity |
| title | Transpupillary Thermotherapy in the Management of Choroidal Melanoma |
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