The expanding role of laser photocoagulation for intraocular tumors. The 1993 H. Christian Zweng Memorial Lecture

Abstract

Background: Methods of management for intraocular tumors include observation, radiotherapy, surgery, and laser therapy. Indications for and techniques of laser photocoagulation in the management of intraocular tumors have never been clearly defined in one report, however.

Methods: A review of selected cases of choroidal and retinal tumors treated with laser therapy between 1974 and 1993 was conducted, as was the literature on laser treatment of intraocular tumors. Based on these observations, indications for, techniques of, and results of laser treatment of selected intraocular tumors are discussed.

Results: The results suggest that the preferred technique of laser treatment varies with the type of tumor. Small melanomas are treated by two or three sessions of laser around the tumor and subsequent heavy treatment directly to the tumor. Choroidal nevus with serous detachment of the fovea is treated by either delimiting laser or direct treatment of focal leaks, depending on the distance of the lesion from the foveola. Choroidal hemangiomas are treated by light to medium photocoagulation over the tumor surface to create chorioretinal adhesion and reattachment of the retina. A small retinoblastoma is best treated by surrounding the tumor with heavy laser to destroy its blood supply without treating the lesion directly. Retinal capillary hemangioma can be treated by heavy direct laser application to the tumor, or by obliterating first the feeding artery and later the draining vein.

Conclusion: Laser photocoagulation is an acceptable therapeutic option for selected benign and malignant intraocular tumors, and its role in the overall management of patients with intraocular tumors is expanding.