Abstract
Objective: To determine the highest safe treatment temperature, at 30- and 60-second exposure durations, for transscleral thermotherapy (TSTT) of choroidal melanoma.
Methods and Design: Transscleral conductive heating was performed in 15 rabbits at 50C to 70C for 30 or 60 seconds. The thermal lesions in the ocular fundus were monitored for 4 months with ophthalmoscopic, photographic, and fluorescein angiographic examination. Histologic examination included polarized light microscopy.
Results: The effect of TSTT was similar for both exposure durations. Vascular occlusion in the retina and choroid developed at temperatures of 55C and higher. After heating at 60C. scleral collagen fibers developed a minimal undulation: at 65C, they became clearly undulated. The undulation resolved in the 3 to 4 months after heating, Heating at 70C caused persistent severe damage to the sclera. Retinal tears developed after heating at 65C and 70C.
Conclusions: A temperature of 65C was found to be the highest temperature that did not cause permanent damage to the sclera at both exposure durations. A temperature of 60C may be the optimal temperature for TSTT of choroidal melanoma because retinal tears may develop at 65C.
Clinical Relevance: In TSTT, the temperature levels reached are cytotoxic for choroidal melanoma as well as intrascleral tumor cells. Occlusion of choroidal vessels induced by TSTT may contribute to tumor necrosis because these vessels serve as feeder vessels for the tumor. Arch Ophthalmol. 2003;121:510-516.
| Original language | English |
|---|---|
| Pages (from-to) | 510-516 |
| Number of pages | 7 |
| Journal | Archives of ophthalmology |
| Volume | 121 |
| Issue number | 4 |
| Publication status | Published - Apr 2003 |
Keywords
- TRANSPUPILLARY THERMOTHERAPY
- UVEAL MELANOMA
- CHOROIDAL MELANOMAS
- BETA-IRRADIATION
- JOINT CAPSULE
- YAG LASER
- DAMAGE
- HYPERTHERMIA
- EXPERIENCE
- NECROSIS