The Clinical Feature and Treatment Outcome of Ocular Melanoma: A 34-Year Experience in a Tertiary Referral Center

Abstract

Malignant melanoma can arise from melanocytes in various structures of the eye, orbit, and ocular adnexa. We reviewed the clinical features and long-term results of all subjects with histologically proved melanoma originating from any of the ocular and periocular structures in a tertiary referral center. Overall, 88 patients including 47 men were recruited. The tumor was primarily located in the uvea, followed by the conjunctiva, orbit, eyelid, and lacrimal sac. Patients with uveal melanoma were diagnosed at a relatively younger age (47.0 years), while those with orbital and eyelid melanomas were older at presentation (79.5 years and 78.5 years, respectively). The overall local recurrence rate was 9% at a median follow-up of 41.0 months, among which orbital and eyelid melanomas recurred most commonly. The overall mortality rate was 41% in a median duration of 27.2 months (IQR, 13–58 months) from diagnosis, with the highest for lacrimal sac melanoma, followed by melanoma of the orbit, uveal, conjunctiva, and eyelid. Despite prompt local control, the risk for metastasis and mortality was high. Therefore, efficient modalities for early diagnosis and treatment of ocular melanoma are necessary.

Biological characteristics and clinical management of uveal and conjunctival melanoma

“…Proton beam radiotherapy and gamma knife radiotherapy are also frequently used, providing an eye-preserving option with effective local control, particularly in the posterior pole. Potential complications of these therapies include an elevated risk of IOP, cataract formation, and optic neuropathy [ 11 , 13 , 22 , 23 , 25 ]. Additionally, other local treatment options, such as transpupillary thermotherapy, photocoagulation, and photodynamic therapy, are often combined with radiation techniques to decrease the risk of metastasis [ 11 , 13 , 26 , 27 ].…”