Long-term results of primary transpupillary thermal therapy to treat choroidal malignant melanoma have shown that the therapy is useful, but the study authors said that it should be used in specific cases.

The retrospective study by Thomas M. Aaberg Jr., MD, and colleagues examined 135 patients who had choroidal melanoma treated with primary transpupillary thermal therapy (TTT). A statistical analysis was performed on data pertaining to patient demographics, tumor characteristics, treatment responses and complications, visual acuity outcomes and mortality.

The researchers found that 76% of patients had successful tumor regression. Regarding the 32 patients for whom primary TTT failed, 12 had enucleation and 20 irradiation. Metastatic disease occurred in three patients, and two of the patients died.

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Final visual acuity was 20/40 or better in 50% of the patients, while 32% had a final visual acuity of 20/200 or worse.

The study found that 32% of patients developed at least one complication as a result of the primary TTT treatment, noting that the most concerning complication was intra- or extrascleral extension of the tumor, which occurred in 11 patients.

The researchers said the treatment "should probably be reserved for specific cases, such as monocular patients with tumors near critical visual structures, surgically unstable patients or patients with advanced diabetic retinopathy."

The study is published in the June issue of British Journal of Ophthalmology.