Uveal Melanoma: Phototherapy

  • Heinrich HeimannEmail author
  • Michael I. Seider
  • Bertil E. Damato


Several types of phototherapy for uveal melanoma exist. Methods such as transpupillary thermotherapy and photodynamic therapy remain in common use, whereas others such as photocoagulation are important for historical context. AU-011 is a novel photosensitizing agent which has shown some promise for treating smaller melanomas. In general, phototherapy of uveal melanomas is less reliable than radiotherapy and is therefore not widely deployed as primary treatment.


Transpupillary thermotherapy Choroidal melanoma Aura AU-011 Photodynamic therapy Photocoagulation 


  1. 1.
    Singh AD. Ocular phototherapy. Eye. 2013;27(2):190–8.PubMedCrossRefGoogle Scholar
  2. 2.
    Houston SK, Wykoff CC, Berrocal AM, et al. Lasers for the treatment of intraocular tumors. Lasers Med Sci. 2013;28(3):1025–34.PubMedCrossRefGoogle Scholar
  3. 3.
    Konstantinidis L, Groenewald C, Coupland SE, et al. Long-term outcome of primary endoresection of choroidal melanoma. Br J Ophthalmol. 2014;98(1):82–5.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Cassoux N, Cayette S, Plancher C, et al. Choroidal melanoma: does endoresection prevent neovascular glaucoma in patient treated with proton beam irradiation? Retina. 2013;33(7):1441–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Hykin PG, Shields CL, Shields JA, et al. The efficacy of focal laser therapy in radiation-induced macular edema. Ophthalmology. 1998;105(8):1425–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Aaberg TM Jr. Laser for choroidal melanoma. Int Ophthalmol Clin. 2006;46(1):15–26.PubMedCrossRefGoogle Scholar
  7. 7.
    Shields CL, Shields JA, Perez N, et al. Primary transpupillary thermotherapy for small choroidal melanoma in 256 consecutive cases: outcomes and limitations. Ophthalmology. 2002;109(2):225–34.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Mashayekhi A, Shields CL, Rishi P, et al. Primary transpupillary thermotherapy for choroidal melanoma in 391 cases: importance of risk factors in tumor control. Ophthalmology. 2015;122(3):600–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Foulds WS, Damato BE. Low-energy long-exposure laser therapy in the management of choroidal melanoma. Graefes Arch Clin Exp Ophthalmol Albrecht Von Graefes Arch Für Klin Exp Ophthalmol. 1986;224(1):26–31.CrossRefGoogle Scholar
  10. 10.
    Tsai T, O’Brien JM, Engstrom R, et al. Extrascleral extension of a choroidal melanoma after argon photocoagulation and transpupillary thermotherapy. Br J Ophthalmol. 2002;86(3):358–9.PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Currie ZI, Rennie IG, Talbot JF. Iatrogenic choroidal neovascularisation following argon laser photocoagulation for choroidal malignant melanoma. Graefes Arch Clin Exp Ophthalmol Albrecht Von Graefes Arch Für Klin Exp Ophthalmol. 1996;234(4):221–6.CrossRefGoogle Scholar
  12. 12.
    Singh AD, Kivelä T, Seregard S, et al. Primary transpupillary thermotherapy of “small” choroidal melanoma: is it safe? Br J Ophthalmol. 2008;92(6):727–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Shields CL, Cater J, Shields JA, et al. Combined plaque radiotherapy and transpupillary thermotherapy for choroidal melanoma: tumor control and treatment complications in 270 consecutive patients. Arch Ophthalmol. 2002;120(7):933–40.PubMedCrossRefGoogle Scholar
  14. 14.
    Bartlema YM, Oosterhuis JA, Journée-De Korver JG, et al. Combined plaque radiotherapy and transpupillary thermotherapy in choroidal melanoma: 5 years’ experience. Br J Ophthalmol. 2003;87(11):1370–3.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Kreusel K-M, Bechrakis N, Riese J, et al. Combined brachytherapy and transpupillary thermotherapy for large choroidal melanoma: tumor regression and early complications. Graefes Arch Clin Exp Ophthalmol Albrecht Von Graefes Arch Für Klin Exp Ophthalmol. 2006;244(12):1575–80.CrossRefGoogle Scholar
  16. 16.
    Desjardins L, Lumbroso-Le Rouic L, Levy-Gabriel C, et al. Combined proton beam radiotherapy and transpupillary thermotherapy for large uveal melanomas: a randomized study of 151 patients. Ophthalmic Res. 2006;38(5):255–60.PubMedCrossRefGoogle Scholar
  17. 17.
    Robertson DM. TTT as rescue treatment for choroidal melanoma not controlled with iodine-125 brachytherapy. Ocul Immunol Inflamm. 2002;10(4):247–52.PubMedCrossRefGoogle Scholar
  18. 18.
    De Potter P, Jamart J. Adjuvant indocyanine green in transpupillary thermotherapy for choroidal melanoma. Ophthalmology. 2003;110(2):406–13. discussion 413–414.PubMedCrossRefGoogle Scholar
  19. 19.
    Win PH, Robertson DM, Buettner H, et al. Extended follow-up of small melanocytic choroidal tumors treated with transpupillary thermotherapy. Arch Ophthalmol. 2006;124(4):503–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Murthy R, Honavar SG, Naik M, et al. Clinicopathologic findings in choroidal melanomas after failed transpupillary thermotherapy. Am J Ophthalmol. 2004;137(3):594–5. author reply 595–596.PubMedCrossRefGoogle Scholar
  21. 21.
    Parrozzani R, Boccassini B, De Belvis V, et al. Long-term outcome of transpupillary thermotherapy as primary treatment of selected choroidal melanoma. Acta Ophthalmol. 2009;87(7):789–92.PubMedCrossRefGoogle Scholar
  22. 22.
    Browning DJ, Antoszyk AN. Retinal tear and detachment after transpupillary thermotherapy for choroidal melanoma. Am J Ophthalmol. 2003;135(5):729–30.PubMedCrossRefGoogle Scholar
  23. 23.
    Mashayekhi A, Shields CL, Lee SC, et al. Retinal break and rhegmatogenous retinal detachment after transpupillary thermotherapy as primary or adjunct treatment of choroidal melanoma. Retina. 2008;28(2):274–81.PubMedCrossRefGoogle Scholar
  24. 24.
    Kashani AH, Aaberg TM Jr, Capone A Jr. Vitreomacular traction as a consequence of posterior hyaloidal contraction after transpupillary thermotherapy. Am J Ophthalmol. 2013;155(5):937–945.e1.PubMedCrossRefGoogle Scholar
  25. 25.
    Tuncer S, Kir N, Shields CL. Dramatic regression of amelanotic choroidal melanoma with PDT following poor response to brachytherapy. Ophthalmic Surg Lasers Imaging. 2012;43(3):e38–40.PubMedGoogle Scholar
  26. 26.
    Fabian ID, Stacey AW, Papastefanou V, et al. Primary photodynamic therapy with verteporfin for small pigmented posterior pole choroidal melanoma. Eye (Lond). 2017;31(4):519–28.CrossRefGoogle Scholar
  27. 27.
    Donaldson MJ, Lim L, Harper CA, et al. Primary treatment of choroidal amelanotic melanoma with photodynamic therapy. Clin Exp Ophthalmol. 2005;33(5):548–9.PubMedCrossRefGoogle Scholar
  28. 28.
    Campbell WG, Pejnovic TM. Treatment of amelanotic choroidal melanoma with photodynamic therapy. Retina. 2012;32(7):1356–62.PubMedCrossRefGoogle Scholar
  29. 29.
    Barbazetto IA, Lee TC, Rollins IS, et al. Treatment of choroidal melanoma using photodynamic therapy. Am J Ophthalmol. 2003;135(6):898–9.PubMedCrossRefGoogle Scholar
  30. 30.
    Jmor F, Hussain RN, Damato BE, et al. Photodynamic therapy as initial treatment for small choroidal melanomas. Photodiagn Photodyn Ther. 2017;20:175–81.CrossRefGoogle Scholar
  31. 31.
    Trichopoulos N, Damato B. Photodynamic therapy for recurrent hyphema after proton beam radiotherapy of iris melanoma. Graefes Arch Clin Exp Ophthalmol Albrecht Von Graefes Arch Klin Exp Ophthalmol. 2007;245(10):1573–5.CrossRefGoogle Scholar
  32. 32.
    Rundle P. Treatment of posterior uveal melanoma with multi-dose photodynamic therapy. Br J Ophthalmol. 2014;98(4):494–7.PubMedCrossRefGoogle Scholar
  33. 33.
    Kines RC, Varsavsky I, Choudhary S, et al. An infrared dye-conjugated virus-like particle for the treatment of primary uveal melanoma. Mol Cancer Ther. 2018;17(2):565–74.CrossRefGoogle Scholar
  34. 34.
    Damato B. Ocular tumours: diagnosis and treatment. Oxford: Butterworth-Heinemann; 2000.Google Scholar
  35. 35.
    Damato B. Vasculopathy after treatment of choroidal melanoma. In: Joussen AM, Gardner TW, Kirchhof B, Ryan SJ, editors. Retinal vascular disease. Berlin, Heidelberg: Springer; 2007. p. 582–91.Google Scholar
  36. 36.
    Singh AD, Rundle PA, Berry–Brincat A, et al. Extrascleral extension of choroidal malignant melanoma following transpupillary thermotherapy. Eye. 2004;18:91–3.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Heinrich Heimann
    • 1
    Email author
  • Michael I. Seider
    • 2
    • 3
  • Bertil E. Damato
    • 4
  1. 1.Liverpool Ocular Oncology ServiceRoyal Liverpool University HospitalLiverpool, MerseysideUK
  2. 2.Department of OphthalmologyThe Permanente Medical GroupSan FranciscoUSA
  3. 3.University of California – San FranciscoSan FranciscoUSA
  4. 4.Nuffield Department of Clinical NeurosciencesUniversity of Oxford, John Radcliffe HospitalOxfordUK

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