Uveal Melanoma

Uveal melanoma is a type of cancer that develops in the uvea, which is the pigmented layer of the eye. The uvea consists of three parts: the iris, ciliary body, and choroid. Uveal melanoma is the most common primary intraocular malignancy in adults, accounting for approximately 5% of all melanomas.

Causes and Risk Factors

The exact cause of uveal melanoma is not known, but several risk factors have been identified. These include:

• Light eye color: Individuals with light-colored eyes are more susceptible to developing uveal melanoma.
• Fair skin: People with fair skin are at higher risk of developing uveal melanoma.
• Family history: A family history of uveal melanoma or other types of melanoma increases the risk.
• Exposure to ultraviolet (UV) radiation: Prolonged exposure to UV radiation from the sun or tanning beds may increase the risk of developing uveal melanoma.

Symptoms

Uveal melanoma often develops without noticeable symptoms in its early stages. However, as the tumor grows, it can cause:

• Blurred vision or double vision
• Flashing lights or floaters in the eye
• Pain or discomfort in the eye
• Sensitivity to light
• A growing dark spot on the iris or choroid

Diagnosis

Uveal melanoma is typically diagnosed through a combination of:

• Ophthalmoscopy: A thorough examination of the eye using an ophthalmoscope.
• Ultrasound biomicroscopy (UBM): High-frequency ultrasound imaging to evaluate the tumor's size and shape.
• Fluorescein angiography: A diagnostic test that uses a special dye to highlight blood vessels in the eye.
• Biopsy: A tissue sample may be taken for histopathological examination, although this is not always necessary.

Treatment Options

Treatment for uveal melanoma depends on the tumor's size, location, and stage. Common treatment options include:

• Enucleation: Surgical removal of the eye.
• Brachytherapy: Placing a radioactive implant near the tumor to deliver targeted radiation therapy.
• External beam radiation therapy (EBRT): Focused radiation beams from outside the body to target the tumor.
• Transpupillary thermotherapy (TTT): Laser treatment that uses heat to destroy the tumor.
• Local resection: Surgical removal of the tumor while preserving the eye.

Prognosis and Follow-up

The prognosis for uveal melanoma varies depending on the tumor's size, location, and stage at diagnosis. Regular follow-up appointments with an ophthalmologist are essential to monitor for recurrence or metastasis. The 5-year survival rate for patients with uveal melanoma is approximately 80%, although this can vary depending on individual factors.