Transpupillary thermotherapy effective in treating many choroidal melanomas
“Transpupillary thermotherapy has been a subject of some controversy recently, and I disagree with some of the things that have been said and written,” Jerry A. Shields, MD, said at Macula 2014.
He showed a case in which transpupillary thermotherapy (TTT) reduced a pigmented lesion within about 3 months.
“I can tell you that if we had used proton beam or plaque radiotherapy, we would not have had such a good result,” Shields said. “So, there’s still a role for it. … We found some long-term problems, but they can be managed.”
Plaque radiotherapy is a sound alternative for tumors involving the optic disc, Shields said.
“Plaque radiotherapy rather than enucleation is an acceptable method for most choroidal melanomas that touch, surround and obscure the disc. We’ve treated well over 1,000 cases,” he said.
Combined treatment has also been shown to be effective.
“Most of the time today, we combine plaque radiotherapy with TTT, so-called sandwich treatment, and you can see the result, before and after, with disappearance of the tumor and the retinal detachment,” Shields said.
Plaque radiotherapy may also be used for corneal melanoma, he said.
"It’s much better if you can remove these tumors locally and leave everything else intact,” he said.
Disclosure: Shields has no relevant financial disclosures.