Laser and proton radiation to reduce uveal melanoma-associated exudative retinal detachments.

PURPOSE To assess whether laser-induced hyperthermia in conjunction with proton irradiation of choroidal melanoma may more rapidly decrease exudative retinal detachments. DESIGN Case-control study. METHODS This was a single-center prospective phase 1 study of choroidal melanoma patients with exudative retinal detachments. These tumors did not overhang the optic disc, involve the fovea, or have greater than 40% involvement of the ciliary body. Patients were treated with laser-induced hyperthermia and proton radiation; results were compared with those of similar patients treated at the same institution with only proton radiation. Patients were followed up in an identical manner for loss of subretinal fluid, visual acuity change, and visual field alterations. RESULTS All 11 patients treated with combined laser and proton therapy had resorption of subretinal fluid with a mean duration of retinal detachment of 193 days, compared with 263 days in the group treated with only proton therapy (P<.04). At 1 year, visual acuity was similar in both groups. CONCLUSIONS Combined laser-induced hyperthermia and proton radiation may dissipate exudative detachments more rapidly than radiation alone.