Aims To investigate the success and recurrence rates and visual outcomes in a large case series of amelanotic posterior choroidal melanomas treated by means of primary photodynamic therapy (PDT) with verteporfin.
Methods Retrospective case series from a single specialist ocular oncology centre. All patients had a clinical diagnosis of choroidal melanoma and were selected for PDT based on tumour characteristics. Included patients had at least 24 months of follow-up from initiation of treatment and all but one had not received treatment prior to PDT.
Results 69 patients were included. Mean tumour thickness was 1.9 mm (range 0.5–4.4), while the mean basal diameter was 6.9 mm (range 2.4–11.0). Included lesions were stage cT1a (n=66) or cT2a (n=3). The mean duration of follow-up from treatment initiation was 57 months (range 24–116 months). Seven lesions (10%) failed to respond to PDT. 10 patients (16%) experienced recurrence during follow-up. Overall success rate in this series was 75% (n=52). 83% of successfully treated patients (n=43) maintained or gained vision by final follow-up. Visual outcomes were significantly better in those patients who received PDT therapy alone in comparison to those who needed other treatments for their melanoma (Fisher’s exact test, p=0.004). Unfortunately, one patient (1.4%) in the series developed systemic metastases and died.
Conclusion Selected amelanotic posterior uveal melanomas may be successfully treated with PDT with retention of good vision in the majority of cases, maintained with a mean of 57 months (minimum of 24 months) of follow-up.
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Contributors HQ contributed to the design of the work, participated in data collection, analysis and interpretation, and wrote the manuscript. DG participated in data analysis and interpretation, and contributed to the revision of the final manuscript. KS aided data acquisition and analysis, and revised the final manuscript. PR provided the conception and design of the work, participated in data acquisition and interpretation, and revised the manuscript.
Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Data sharing statement All data relevant to the study are included in the article or uploaded as supplementary information.
Ethics statement This retrospective study was performed as a service evaluation and as such NHS Ethical Approval was not required.
Provenance and peer review Not commissioned; externally peer reviewed.