Transpupillary thermotherapy versus plaque radiotherapy for suspected XXXX .

@entity1 @entity5 @entity320 @entity3
PURPOSE: To examine the outcomes and complications of transpupillary thermotherapy for treatment of small @entity320 . DESIGN: Retrospective case-matched comparative study and retrospective observational study. @entity1 : The case-matched study consisted of 36 @entity1 treated with either transpupillary thermotherapy or plaque radiotherapy (18 @entity1 per group). The observational study consisted of 21 @entity1 treated with transpupillary thermotherapy alone (primary transpupillary thermotherapy) and 9 @entity1 treated with transpupillary thermotherapy plus plaque radiotherapy (adjuvant transpupillary thermotherapy). MAIN OUTCOME MEASURES: Visual acuity, @entity5 control, and @entity3 . RESULTS: The case-matched groups did not differ significantly with respect to age, gender, initial visual acuity, @entity5 location, or length of follow-up (mean, 33 months for transpupillary thermotherapy vs. 40 months for plaque radiotherapy). There was no significant difference in final visual acuity (P = 0.810) or postoperative visual acuity change (P = 0.919) between the 2 groups. In the observational study, the mean follow-up was 32 months (range, 4-58 months). Indications for primary transpupillary thermotherapy included documented growth (10 @entity1 ) and the presence of >/=3 risk factors for growth (11 @entity1 ). Retinal complications occurred in 16 @entity1 (76%). The mean posttreatment visual acuity change was minus 2 lines (range, minus 9 to plus 7 lines). Local failure occurred in 6 @entity1 (29%). Local failure was associated with an increased number of transpupillary thermotherapy spots per session (P = 0.023) and decreased @entity5 pigmentation (P = 0.001). Indications for adjuvant transpupillary thermotherapy included @entity5 radioresistance (6 @entity1 ) and the presence of risk factors for local failure (3 @entity1 ). All 9 @entity5 that received adjuvant transpupillary thermotherapy regressed rapidly, with no local failures. The mean postoperative visual acuity change was -1.9 lines (range, -9 to +5 lines). No @entity1 in either study developed @entity3 . CONCLUSIONS: The recent interest in transpupillary thermotherapy as primary therapy for @entity320 is based largely on the assumption that transpupillary thermotherapy may provide better visual outcomes than plaque radiotherapy. However, this study found no significant difference in visual outcomes between transpupillary thermotherapy and plaque radiotherapy. Further, the local failure rate with transpupillary thermotherapy was substantially higher than with plaque radiotherapy. The most promising role for transpupillary thermotherapy seems to be as an adjunct to plaque radiotherapy. The appropriate indications for transpupillary thermotherapy in the management of @entity320 need to be re-evaluated.
