J.ophthalmol.(Ukraine).2019;3:36-40.

Received: 21 May2019; Published on-line: 27 June 2019

http://doi.org/10.31288/oftalmolzh201933640


Efficacy of 810-nm diode laser transpupillary thermotherapy delivered using the methodology developed for small (T1) choroidal melanomas

I.V. Tsukanova, Junior Research Associate; S.I. Poliakova, Dr Sc (Med); V.O. Naumenko, Dr Sc (Med), Prof.; N.V. Pasyechnikova, Assoc. Member of the NAMS of Ukraine, Dr Sc (Med), Prof.

Filatov Institute of Eye Diseases and Tissue Therapy, NAMS of Ukraine; Odesa (Ukraine)

E-mail: inna.sister@gmail.com

TO CITE THIS ARTICLE: Tsukanova IV, Poliakova SI, Naumenko VO, Pasyechnikova NV. Efficacy of 810-nm diode laser transpupillary thermotherapy delivered using the methodology developed for small (T1) choroidal melanomas. J.ophthalmol.(Ukraine).2019;3:36-40. http://doi.org/10.31288/oftalmolzh201933640


Background: Diode laser transpupillary thermotherapy (TTT) used as a monotherapy may be a treatment of choice for small choroidal melanomas (CM). We developed the methodology for performing TTT, which involves four sessions delivered daily over four consecutive days (Information Bulletin No. 22, based on Pat. of Ukraine №102,890 issued 25.11.2015. Method for treatment of T1 choroidal melanoma), and which we have been using for the treatment of small (T1) CM (measuring ≤ 3 mm in thickness and ≤ 12 mm in basal dimension) for 15 years.

Purpose: To assess the efficacy of 810-nm diode laser TTT delivered using the developed methodology in small tumors differing in magnitude of baseline characteristics.

Materials and Methods: We assessed the efficacy of 810-nm diode laser TTT delivered using the developed methodology for the small (T1) CM (measuring ≤ 3 mm in protrusion into the vitreous and ≤ 12 mm in basal dimension). Eighty-eight patients (63 men (71.6%) and 25 women (28.4%); mean age, 55.9 (12.8) years (range, 23 to 82 years) with small (T1) CM were involved into the study. The right eye was affected in 41 cases (46.6%), and the left eye was affected in the other 47 cases (53.4%). At baseline, no patient had metastasis. Treatment outcome was categorized as positive if partial or complete scarring of the tumor site was observed or negative if tumor growth persisted.

Results: Eighty-one patient (92.05%) reached a positive treatment outcome, and 7 (7.95%) had a negative treatment outcome. In addition, complete scarring or partial scarring was found in 81.5% and 18.5%, respectively, of those with a positive treatment outcome. The treatment outcome in patients even with small (T1) CM (measuring ≤ 3 mm in thickness and ≤ 12 mm in basal dimension) depended on tumor dimensions and tumor area at baseline. Patients with small CM of more than 2.18-mm protrusion into the vitreous, more than 8.45-mm basal dimension, and more than 66.6 mm2 tumor area were 2.80 times more likely to have a negative treatment outcome.

Conclusion: We developed the methodology for performing TTT, which involves four sessions delivered daily over four consecutive days (Information Bulletin No. 22, based on Pat. of Ukraine №102,890 issued 25.11.2015. Method for treatment of T1 choroidal melanoma) for the treatment of small (T1) CM (measuring ≤ 3 mm in thickness and ≤ 12 mm in basal dimension). The success rate of the TTT methodology developed for small (T1) CM (measuring ≤ 3 mm in thickness and ≤ 12 mm in basal dimension) was 92.05%. The efficacy of treatment of small (T1) CM depended on tumor parameters at baseline: patients with a small CM measuring < 2 mm in thickness, < 8 mm in basal dimension, and < 66 m2 in area were more likely to have a positive treatment outcome in the form of scarring of the tumor site in 81.5% of cases.

Keywords: choroidal melanoma, diode laser transpupillary thermotherapy

References

1.Bulgakova ES. [Treatment of small choroidal melanomas with diode laser transpupillary thermotherapy]. [Abstract of Cand Sc (Med) Thesis]. Moscow: Helmholtz Research Institute for Eye Diseases; 2005. 25 p. Russian.

2.Bukhtiiarova NV. [Transpupillary thermotherapy in the multicomponent organ-sparing treatment of choroidal melanoma]. [Abstract of Cand Sc (Med) Thesis]. Cheliabinsk: Ural State Medical Academy of Additional Education; 2006. 22 p. Russian.

3.Iarovoi AA, Linnik LF, Magaramov DA, et al. [Diode laser transpupillary thermotherapy: the potential for the treatment of small choroidal melanomas]. Russkii meditsinskii zhurnal. 2004;5(2):77–81. Russian.

4.Ushenina LA. [Optimization of laser treatment for early choroidal melanoma]. [Cand Sc (Med) Thesis]. Cheliabinsk: Ural State Medical Academy of Additional Education; 2008. 114 p. Russian.

5.Damato B, Lecuona K.  Conservation of Eyes with Choroidal Melanoma by a Multimodality Approach to Treatment: An audit of 1632 Patients. Ophthalmology. 2004 May;111(5):977-83.

Crossref    PubMed

6.Damato B. Developments in the management of uveal melanoma. Clin Exp Ophthalmol. 2004 Dec;32(6):639-47.

Crossref    PubMed

7.De Potter P, Levecq J. [Transpupillary thermotherapy in the treatment of choroid melanoma]. J Fr Ophtalmology. 2001 Nov;24(9):937-43. French.

8.De Potter P. [Treatment of intraocular melanoma: new concepts]. Bull Men Acad R Med Belg. 2003;158(1-2):103-11. French.

9.V.V. Volkov. [Laser treatment of intraocular melanoma]. Russkii meditsinskii zhurnal. 2001;2(1):3–7. Russian.

10.Mazunin IIu. [New treatment methods in pathologies of the choroid and retina including the use of subthreshold power od fiode infrared laser radiation]. Vestn Oftalmol. 2005 Jan-Feb;121(1):49-54. Review. Russian.

11.Currie ZI, Rennie IG, Talbot JF. Retinal vascular changes associated with transpupillary thermotherapy for choroidal melanomas. Retina. 2000;20(6):620-6.

Crossref    PubMed  

12.De Potter P, Jamart J. Adjuvant indocyanine green in transpupillary thermotherapy for choroidal melanoma. Ophtalmology. 2003 Feb;110(2):406-13.

Crossref   

13.Diener-West M, Reynolds SM, Agugliaro DJ, et al.  Development of Metastatic Disease after Enrollment in the COMS Trials for Treatment of Choroidal Melanoma. Collaborative Ocular Melanoma Study Group Report No. 26. Arch Ophthalmol. 2005 Dec;123(12):1639-43.

Crossref   PubMed  

14.Journee–de Korver JG, Oosterhuis JG, de Wolff–Rouendaal D, Kemme H. Histopathological findings in human choroidal melanomas after transpupillary thermotherapy. Brit J Ophthal. 1997 Mar;81(3):234-9.

Crossref  PubMed

15.Kiratli H, Bilgiç S, Söylemezoglu F, Alaçal S. Peripheral subretinal pigment accumulation following transpupillary thermotherapy for choroidal melanoma. Ophthalmic Surg Lasers Imaging. 2008 Jan-Feb;39(1):60-2.

Crossref   PubMed  

16.Shields CL, Shields JA, Perez N, et al.  Primary transpupillary thermotherapy for small choroidal melanoma in 256 consecutive cases: outcomes and limitations. Ophthalmology. 2002 Feb;109(2):225-34.

Crossref    

17.Shields CL, Shields JA, Kiratli H, et al. Risk factors for growth and metastasis of small choroidal melanocytic lesions. Ophthalmology. 1995 Sep;102(9):1351-61.

Crossref   

18.Shields CL, Shields JA, Cater J, et al. Plaque radiotherapy for uveal melanoma: long–term visual outcome in 1106 consecutive patients. Arch Ophthalmol. 2000 Sep;118(9):1219-28.

Crossref   PubMed

19.Shields CL, Shields JA. Clinical features of small choroidal melanoma. Curr Opin Ophthalmol. 2002 Jun;13(3):135-41.

Crossref   PubMed  

The authors certify that they have no conflicts of interest in the subject matter or materials discussed in this manuscript.