Object: choroidal melanoma stage T1N0M0 (ICD 10 – malignant uveal tumor). Purpose: to increase the effectiveness of treatment of choroidal melanoma stage T1N0M0 (standing – up to 3,0 mm, length of the base – up to 12,0 mm) by using transpupillary thermotherapy as a monotherapy based on a modified methodology due to clinical characteristics of the tumor. Methods: visometry, the inspection of peripheral eyes hot and campymetry, measuring of ophthalmotonus, refractometry,ophthalmoscopy,biomicroscopy, optical coherent tomography, fluorescent angiography, ultrasonic research of eye and organs of abdominal region, sciagraphy of lungs are immunological, hystomorphology, electronic-microscopical, statistical methods of research -"Statistica 10.0". It is first set that intensity of destructive changes in a tumour parenchima (balonocells degeneration, dry and moist necrosis) that is accompanied by destructional cytolemma with deep destruction of organoids, especially mythohondries, and by complete or partial absence of chromoplasmin kernels, and also by the destructive changes of walls of blood vessels and their thrombosis, acquires a maximum on a fourth day after influence of transpupillary thermotherapy. It was proved that the choroidal melanoma stage T1N0M0 (standing – up to 3,0 mm, length of the base – up to 12,0 mm) on the initial stage of tumour process is accompanied by the increase of activity of cellular and humoral immunity and natural antitumoral resistence of organism and activating of expression on lymphocytes of peripheral blood of markers of CD7+, СD25+, CD38+, CD45+, CD54+, CD95+, CD150+. It was first edused that transpupillary thermotherapy influences on the antitumoral immune answer, that shows the increasing of activating of expression on peripheral blood lymphocytes of costimulatory molecula CD7+ (on 59,14; р =0,04), that induces the secretion of cytocines and marker of activating of lymphocytes CD95+ (on 40,86; р = 0,05), that promotes proapoptosy activity of lymphocytes, that assists realization of curative effect. Methodology of transpupillary thermotherapy is modified of choroidal melanoma stage T1N0M0 (standing – up to 3,0 mm, length of the base – up to 12,0 mm), what consists in realization of daily, one time a day of sessions of transpupillary thermotherapy four days in succession with an interval between the courses of treatment 2-3 months for a year to the receipt of complete resorption of tumour and possibility of her use as monotherapy (patent of Ukraine №102890). A test is worked out (sensitivity - 88,2; specificity - 82,4) of positive prognosis (complete and partial resorption of tumour ≤ 2,0 mm) or negative (the continued growth of tumour ≥ 2,0 mm) for local result of treatment of patients with the choroidal melanoma of stage T1N0M0 (standing – up to 3,0 mm, length of the base -up to 12,0 mm) depending on a standing of tumour (frontier value = 2,0 mm) in a vitreous body due to ultrasonic scanning of eyeball. The method of treatment of choroidal melanoma stage T1N0M0 (standing – up to 3,0 mm, length of the base – up to 12,0 mm) was optimized by modification of transpupillary thermotherapy with high efficiency of the received local result (92,1%) including complete tumour resorption in 81,5% cases and the algorithm of examination and treatment of such patients is worked out. The results of the work were introduced into the clinical practice of department of ophthalmooncology and department of study of biological action and use of laser ophthalmology of SI «The Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine» and LTD «Clinic of professors of Filatov Institute». Scope – medicine, ophthalmology.
