Transpupillary thermotherapy for three kinds of intraocular benign tumors / 中华眼底病杂志

ABSTRACT

Objective To evaluate the efficacy of transpupillary thermotherapy(TTT)on three kinds of intraocular benign tumors. Methods Seventeen patients with 3 kinds of intraocular tumors,3 eyes of 3 patients with papillary hemangioma,9 eyes of 9 patients with choroidal hemangioma and 8 eyes of 5 patients with choroidal osteoma were treated with transpupillary thermotherapy.All patients underwent pretreatment ocular examination,including visual acuity,biomicroscopy for anterior segment and fundus examination,fundus fluorescein and indocyanine green angiography,optic coherence tomography,perimetry test,ultrasonography,and CT.TTT was conducted with infrared diode laser at810nm.with power of 360- 1 200 mW; beam diameter of 3 mm or combined 2-5 spots according to the tumor size;the exposure time was 60-80 seconds.The treatment was completed in one session,and another treatment was given 1-3 month later if active leakage demonstrated.The follow-up period was 6-36 months(mean 14.5 month). Results The best corrected visual acuity with Snellen chart on average for papillary hemangioma was 0.17 before TTT and 0.27 after;for choroidal hemangioma was 0.39 before TTT and 0.46 after;for choroidal osteoma was 0.20 before TTT and 0.31 after.Three eyes with papillary hemangioma had operation to release subretinal fluid and intraocular laser coagulation;the tumor remained reddish color with dilated vessels and patches of hemorrhages on the surface.After TTT the color appeared pale yellowish,hemorrhages absorbed,subretinal fluid subsided,and choroidal retinal atrophy disclosed along the lower border of the tumor.In 9 eyes with choroidal hemangioma, the red-light area disappeared, subretinal fluid subsided, and the pigment proliferation in the treatment area was found.Eight eyes with choroidal osteoma had choroidal neovessels and macular hemorrhages;after TTT blood disappeared,subretinal fluid absorbed,and the color of tumor showed pale yellow with dark pigment and thin scar tissue.There was no significant complication associated with TTT. Conclusions Transpupillary thermotherapy is effective on papillary hemangioma,circumscribed choroidal hemangioma and choroidal osteoma either as preliminary or supplementary treatment.