Treatment of amelanotic choroidal melanoma with photodynamic therapy

Retina. 2012 Jul;32(7):1356-62. doi: 10.1097/IAE.10.1097/IAE.0b013e31822c28ec.


Purpose: To evaluate the effect of photodynamic therapy on amelanotic choroidal melanoma.

Methods: Nine patients with posteriorly located amelanotic choroidal melanomas, one with a pigmented portion, underwent photodynamic therapy using verteporfin as the photosensitizing agent. The basal diameters ranged from 4 mm to 16 mm and the heights from 1.3 mm to 5.7 mm. Treatment was repeated until the melanoma was completely flat or its height had reached a stable end point. Tumor response was assessed by clinical examination, photography, and ultrasonography. Annual screening for hepatic metastases was performed.

Results: Eight tumors demonstrated apparent complete regression over 1 month to 14 months. The amelanotic portion of the mixed tumor flattened, whereas the height of the pigmented part remained stable at 2 mm. In 8 patients there has been no recurrence during follow-up of between 34 months and 81 months. One case developed 2 separate local recurrences at 21 months and 34 months. There were no serious complications, no patient lost vision after treatment, and none developed metastatic disease.

Conclusion: In this series photodynamic therapy was highly effective in causing regression of posteriorly located amelanotic choroidal melanomas, without a detrimental effect on vision. While the short-term results are encouraging, there is some uncertainty regarding complete tumor destruction and long-term efficacy.

MeSH terms

  • Adult
  • Aged
  • Choroid Neoplasms / diagnostic imaging
  • Choroid Neoplasms / drug therapy*
  • Choroid Neoplasms / pathology
  • Female
  • Humans
  • Male
  • Melanoma, Amelanotic / diagnostic imaging
  • Melanoma, Amelanotic / drug therapy*
  • Melanoma, Amelanotic / pathology
  • Middle Aged
  • Photochemotherapy*
  • Photosensitizing Agents / adverse effects
  • Photosensitizing Agents / therapeutic use*
  • Porphyrins / adverse effects
  • Porphyrins / therapeutic use*
  • Treatment Outcome
  • Ultrasonography
  • Verteporfin


  • Photosensitizing Agents
  • Porphyrins
  • Verteporfin