'EMORY RESEARCHERS FIND LASER TREATMENT EFFECTIVE FOR EYE TUMOR

April 1998

Media Contacts: Sarah Goodwin, 404/727-3366 - sgoodwi@emory.edu
Kathi Ovnic, 404/727-9371 - covnic@emory.edu
http://www.emory.edu/WHSC/

Early results from research conducted at the Emory Eye Center show that laser treatment using heat therapy is effective for treating patients with eye tumors.

Data from the study show that transpupillary thermotherapy (TPTT) effectively can manage small choroidal melanoma (2.6mm or smaller in thickness).

"This laser treatment was successful for 23 of the 24 patients enrolled in our study," said Antonio Capone, Jr., M.D., an Emory retina surgeon and the study's principal investigator. The procedure involves heating the tumor in 1/10-second bursts with an infrared diode laser. The heat destroys the melanoma cells' metabolism.

In the past, patients with intraocular (within the eye) tumors often were treated with radiation.

"Radiation collapses the tumor mass. It can kill the tumor, but it often 'kills' the vision as well," said Dr. Capone. "We can destroy the tumor with surgical precision with the laser."

Side-effects are infrequent with TPTT. Researchers have followed the patients enrolled in the study for up to 30 months.

"We still don't know the procedure's effectiveness on tumor-related mortality over the long-term," reports Dr. Capone. "We will need to follow these patients for five or 10 more years." Dr. Capone's colleague, retina surgeon Thomas Aaberg, Jr., M.D., also performs the procedure.

TPTT is effective in treating retinoblastoma, a type of retinal tumor that occurs mostly in children.

The Emory Eye Center is one of a few centers on the East Coast and the only one in Georgia with a comprehensive ophthalmic oncology section. Retina surgeons here have specialized training and experience in treating patients with ocular melanoma, retinoblastoma and other tumors within the eye. The Eye Center's ophthalmic pathologist provides analysis and diagnosis of tumors, and its diagnostic center provides the most advanced technology available to detect tumors. In addition, Emory's oculoplastic surgeons provide plastic, reconstructive and cosmetic surgery for patients whose eye lids, eye sockets, tear ducts and other eye structures have been damaged by tumor.

What is choroidal melanoma?

Choroidal melanoma is a collection of abnormal, pigmented cells within the choroid, which is the layer of tissue in the back of the eye between the retina and sclera (the white of the eye). Choroidal melanoma is the most common type of primary intraocular tumor in adults. Because this type of tumor occurs inside the eye, it is best detected early by a thorough annual exam of the back of the eye by an ophthalmologist or optometrist. Unlike other melanomas, doctors can see the tumor through the pupil of the eye.

Most choroidal tumors grow slowly. The patient may not recognize something is wrong until his or her vision is impaired by the tumor itself or from retinal detachment or hemorrhaging due to the tumor.

Once diagnosed, ophthalmologists use ultrasonography to classify choroidal melanoma as being small, medium or large. Small tumors (2.6mm or smaller) have a 20 to 30 percent chance of growing to the point at which the only treatment is radiation or removal of the eye. In rare instances, the tumor can spread to the lungs, liver or other major organs, causing death.

Transpupillary thermotherapy (TPTT), a procedure during which an ophthalmologist uses an infrared diode laser to heat and destroy abnormal cells, is a promising new treatment for small tumors.

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