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. 1997 Mar;81(3):234–239. doi: 10.1136/bjo.81.3.234

Histopathological findings in human choroidal melanomas after transpupillary thermotherapy

K Journee-de 1, J Oosterhuis 1, D de Wolff-Rouendaa 1, H Kemme 1
PMCID: PMC1722129  PMID: 9135389

Abstract

AIMS—The effect of transpupillary thermotherapy (TTT) on human choroidal melanomas was investigated by means of histopathology.
METHODS—Before enucleation TTT was performed in 11 eyes with a xenon arc photocoagulator with a red filter or a diode laser at 810 nm. The exposure time was 1 minute; the estimated temperature at the top of the tumour was about 65°C.
RESULTS—Seven of 11 tumours developed necrosis to a maximum depth of 3.9 mm with a sharp demarcation between the necrotic and the viable part of the tumour. The depth correlated with penetration of heat into the tumour. Scattered small haemorrhages in the transitional zone between the necrotic and the viable part of the tumour were observed in three eyes but large haemorrhages were absent. Ocular media were not affected owing to the low rate of absorption of radiation at 810 nm. TTT did not cause significant scleral damage. Intrascleral tumour cells with a viable appearance were observed in one eye, where the tumour was almost totally necrotic.
CONCLUSION—Results show that TTT has potential as a conservative therapeutic treatment for choroidal melanomas.



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Figure 1  .

Figure 1  

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(A) Patient 7. Depigmented haematoxylin and eosin stained section showing transpupillary thermotherapy induced necrosis (N) in a choroidal melanoma with a depth of 3.4 mm, sharply demarcated from the viable part (V) of the tumour without haemorrhages. Retinal necrosis and atrophy correspond with the area of necrosis of the tumour. (B) Haematoxylin and eosin stained section of the same eye as shown in (A) at higher magnification. Sharp demarcation between necrotic (N) and viable (V) parts of the melanoma without haemorrhages.

Figure 3  .

Figure 3  

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Patient 4. Sharp lateral demarcation of transpupillary thermotherapy induced effect in a melanoma (arrowhead), and in retinal (arrows) and subretinal exudate (asterisks).

Figure 6  .

Figure 6  

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Schematic drawing of `sandwich therapy', transpupillary thermotherapy being most effective at the top of the tumour, and brachytherapy at the base of the tumour.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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