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NR 1-3/2009
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Fototromboza
indukowana zieleni± indocyjaninow± (iMP) w leczeniu czerniaka
naczyniówki
Photothrombosis in choroidal
melanoma mediated by indocyanine green
Bożena Romanowska-Dixon, Agnieszka
Kubicka-Trz±ska
Z Kliniki Okulistyki i Onkologii Okulistycznej Katedry
Okulistyki
Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie
Kierownik: dr hab. n. med. Bożena Romanowska-Dixon |
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| Summary: |
Purpose: To assess
the distant results of choroidal melanoma treatment with
indocyanine green induced photothrombosis (iMP).
Material and methods: The study comprised 57
patients (57 eyes) at the age 39 to 68 yrs (mean age:
57.4 yrs), with choroidal melanoma. In all cases basic
ophthalmic examination with ultrasonography and
indocyanine green angiography (ICGA) were performed. IMP
was performed with diode laser at 810 nm wave length 15
minutes after intravenous indocyanine dye injection as a
bolus (50 mg/ 5ml). The main criteria for assessment of
treatment efficacy included changes in tumor thickness
measured by ultrasonography and microcirculation changes
in ICGA. The follow-up period ranged from 37 to 59
months (mean: 45.5 month).
Results: Before iMP plaque therapy with 106Ru was
performed in 18 eyes, and with 125I in 5, transpupillary
thermotherapy (TTT) or xenon arc photocoagulation was
used in 5 eyes and „sandwich method” (106Ru + TTT) in 16
eyes. Only in 13 eyes the primary treatment consisted of
iMP. IMP was performed twice in 4 patients and three
times in 2. After iMP the total regression of tumor
microcirculation was observed in 36 cases, in 14 the
partial regression was noted and in 7 the inner
microcirculation remained unchanged. Ultrasonography
showed the mean reduction of tumor thickness by 47.3% in
37 eyes, among which the flat scar was present in 12.
Stabilization was observed in 15 cases while in 5 the
further progression of the tumor was detected in spite
of performed therapies. The additional treatment was
performed in 20 cases. Six eyes was enucleated; in one
case because of neovascular glaucoma, and in 5 because
of no positive reaction to performed conservative
treatment.
Results: IMP can be an effective method of
therapy in some cases of small choroidal melanoma. In
medium size and in large melanomas iMP can serve only as
the additional method adjunctive to plaque therapy and
TTT. |
| Słowa kluczowe: |
czerniak naczyniówki,
zieleń indocyjaninowa, fototromboza. |
| Key words: |
choroidal melanoma,
indocyanine green, photothrombosis. |
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