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Primary photodynamic therapy with verteporfin for small pigmented posterior pole choroidal melanoma

Fabian, ID; Stacey, AW; Papastefanou, V; Al Harby, L; Arora, AK; Sagoo, MS; Cohen, VML; (2017) Primary photodynamic therapy with verteporfin for small pigmented posterior pole choroidal melanoma. Eye , 31 (4) pp. 519-528. 10.1038/eye.2017.22. Green open access

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Abstract

PURPOSE: The purpose of the study was to investigate the outcomes of primary photodynamic therapy (PDT) for small pigmented posterior pole choroidal melanoma. PATIENTS AND METHODS: Prospective interventional consecutive case series of 15 patients with small pigmented posterior pole choroidal melanoma, who were treated with three sessions of PDT and followed-up thereafter. Risk factors for failure were assessed and outcome measures at presentation were compared to those at last follow-up visit. RESULTS: Tumor control was achieved in 12 (80%) patients in a median follow-up time of 15 months (mean 14, range 8-18). Three patients failed treatment, diagnosed in a median time of 5 months (mean 4, range 3-6), after first PDT. In all failed cases, lesions were 100% pigmented; de novo melanoma rather than transformed nevi and showed a radial growth pattern rather than increased thickness. All failed cases were subsequently successfully treated with radiotherapy. In this cohort, subretinal fluid (SRF) was significantly reduced (P<0.001), vision did not deteriorate (P=0.11) and even improved in patients with subfoveal SRF at presentation (P=0.018), tumor height significantly decreased (P=0.037) and no complications were recorded. CONCLUSION: Primary PDT was found to be a safe and efficient treatment modality for small pigmented posterior pole choroidal melanoma, achieving short-term tumor control in 80% of patients. PDT offers patients the opportunity to preserve vision by avoiding the retinopathy associated with conventional radiation treatments for choroidal melanoma. However, the long-term local control of these tumors remains uncertain.

Type: Article
Title: Primary photodynamic therapy with verteporfin for small pigmented posterior pole choroidal melanoma
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1038/eye.2017.22
Publisher version: http://doi.org/10.1038/eye.2017.22
Language: English
Additional information: Copyright © 2017 Macmillan Publishers Limited, part of Springer Nature. All rights reserved.
Keywords: choroidal melanoma, photodynamic therapy, verteporfin
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/1547028
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