Primary transpupillary thermotherapy for small choroidal melanoma in 256 consecutive cases: outcomes and limitations1 1The authors have no proprietary interests in any of the devices mentioned in this article.

Shields, Carol L.; Shields, Jerry A.; Padrón-Pérez, Noel; Singh, Arun D.; Cater, Jacqueline

doi:10.1016/s0161-6420(01)00902-2

Cited by 207 publications

(129 citation statements)

References 28 publications

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“…[58,59] If the tumor margin touches the optic disc, TTT is not a proper treatment as it may induce thermal papillitis. [60] TTT leads to tumor regression in many patients (42%, complete and 53%, partial regression), however it carries a risk of cystoid macular edema, preretinal fibrosis, focal iris atrophy and retinal vascular occlusion. [58] Gunduz found that all tumors ceased leaking following TTT along with resolution of subretinal fluid.…”

Section: Transpupillary Thermotherapymentioning

confidence: 99%

Circumscribed choroidal hemangioma

Mashayekhi

Shields

2003

Current Opinion in Ophthalmology

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Circumscribed choroidal hemangiomas are benign vascular hamartomas without systemic associations. Generally, they are orange-red elevated masses, which are found posterior to the equator. Lesions are usually solitary and unilateral. Overlying subretinal fluid, serous retinal detachment and cystoid macular edema are common findings. Intravenous fluorescein angiography, indocyanine green angiography, ultrasonography, optical coherence tomography and enhanced depth imaging are helpful ancillary tests for diagnosis of circumscribed choroidal hemangiomas. Asymptomatic circumscribed choroidal hemangiomas do not require treatment. For symptomatic lesions with exudative retinal detachment or cystoid macular edema, photodynamic therapy has emerged as the treatment of choice with high rates of tumor regression, subretinal fluid resorption and minimal complications. Lens-sparing external beam radiotherapy, plaque brachytherapy, proton beam therapy, stereotactic radiosurgery, transpupillary thermotherapy, laser photocoagulation and anti-VEGF injections are other treatment modalities.

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Section: Transpupillary Thermotherapymentioning

confidence: 99%

Circumscribed choroidal hemangioma

Mashayekhi

Shields

2003

Current Opinion in Ophthalmology

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“…Early studies on TTT reported satisfactory and replicable results, but they had a short follow-up time (1)(2)(3)(4) . More recently, different publications have supported a more cautious approach, and there is disagreement regarding the method's results and complications.…”

Section: Discussionmentioning

confidence: 99%

“…The criteria and the technique adopted to indicate and perform TTT can be found in other sources (4) ; essentially, the method was limited to tumours up to 4 mm thick and 12 mm in diameter on ultrasound. Treatment was administered using a slit lamp (Opto, Brazil) under peribulbar block.…”

Section: Methodsmentioning

confidence: 99%

“…Currently, alternative therapeutic methods have been adopted that preserve the eyeball, and even its function, but without affecting the survival rate or the metastatic potential. These alternative therapeutic choices should take into account the patient's overall clinical condition, the affected eye's visual acuity and intraocular pressure, and the tumour's size, location, growth pattern, and activity (4) . Within certain limits, expectant management is adequate; otherwise, therapeutic options include thermotherapy, brachytherapy, external radiotherapy, and surgical resection, among others.…”

mentioning

confidence: 99%

“…The method can produce necrosis up to a maximum depth of 3.9 mm without affecting structures outside the treatment field. Its advantages include a limited field of action, the fact that it does not need to be conducted in an operating theatre, the preservation of the organ and its function (patients with extra-macular foci may retain good visual acuity), and good survival rates (1)(2)(3)(4) .…”

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confidence: 99%

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Falha a longo prazo no tratamento do melanoma de coróide com termoterapia transpupilar

Pasetto¹,

Freitas²,

Colossi³

et al. 2013

Rev. bras.oftalmol.

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RESUMOObjetivo: Avaliar, retrospectivamente, num longo intervalo de tempo, os resultados da termoterapia transpupilar em casos selecionados do melanoma de coróide. Métodos: Foram identificados todos os casos com melanoma de coróide tratados com termoterapia transpupilar, como terapia única ou suplementar. Foram excluídos os casos com seguimento inferior a 60 meses, prontuários incompletos ou com o abandono do acompanhamento. Resultados: De um total de 18 olhos, 7 (38.9%) foram incluídos no estudo. Cinco (71,4%) pacientes foram tratados exclusivamente com termoterapia transpupilar, em 1 (14,2%) olho a crioterapia foi simultânea, 1 (14,2%) suplementou braquiterapia -placa episcleral. Três (42.8%) sofreram recorrência, 2 (28.5%) apresentaram metástases (um óbito), 2 foram enucleados. Complicações foram encontradas em 3 olhos: dobras maculares em 2, hemorragia vítrea em 1. Nos olhos enucleados, não havia extensão extraescleral, porém células interesclerais foram identificadas. Conclusão: Termoterapia transpupilar mostra um declínio em sua eficácia e conserva os riscos de metástases em períodos mais longos de acompanhamento, sendo necessária uma definição mais exata de seu papel nos melanomas de coróide.

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