Current management of choroidal melanoma in Serbia

Introduction/Objective. Uveal melanoma is the most common primary malignant intraocular tumor in adults, and approximately 90% of uveal melanomas originate from the choroid. Nowadays, different treatment options for choroidal melanoma are available and an increasing tendency toward eye-sparing therapies is evident. The aim of this paper is to analyze the current treatment of choroidal melanoma in Serbia. Methods. This was a retrospective, observational study. Included patients were those with choroidal melanoma diagnosed at the Clinic for Eye Disease, Clinical Center of Serbia in Belgrade, between January 2014 and December 2016. Information on patients’ age and gender and suggested and performed therapy was analyzed. Results. During the observation period, a diagnosis of choroidal melanoma was established in 148 patients, 71 (48%) males and 77 (52%) females. Recommended treatment was enucleation in 108 (72.9%), brachytherapy in 24 (16.2%), and proton beam radiation in 16 (10.8%) patients. Fifteen (10.1%) patients did not accept the suggested therapy, 10 (6.8%) patients refused any treatment at all, and five patients insisted on enucleation instead of advised eye-sparing therapies. Conclusion. In our country, choroidal melanoma is usually detected late, when the possibility of an efficient local treatment with preservation of the eye and its function is limited and when the patient’s prognosis is poor. A periodic fundus examination in mydriasis in persons after the age of 50 years plays an important role in early diagnosis of a disease

Iris melanocytoma

Introduction. Iris melanocytoma (IM) is a rare benign tumor, but unavoidable in differential diagnosis of pigmented iris lesions. According to the best knowledge of the authors it is for the first time in Serbia that a well-documented case of IM is presented and that the problem of this tumor is discussed. Case Outline. In the left eye of a 47-year-old white female at the iris in a six o’clock position, a highly pigmented, dome shaped lesion with a crater-like cavity in the center and with feathery margins was noticed. There were no signs of infiltration of surrounding tissue or intrinsic vessels and the lens was clear. Visual acuity and intraocular pressure were normal. An ultrasound biomicroscopy (UBM) revealed a well-defined lesion with high internal reflectivity, with a base diameter of 1.25 mm and a thickness of 0.80 mm in the periphery, and 0.53 mm in the central part. The diagnosis of IM of the left eye was established and regular checkups were performed for ten years. No changes in clinical or UBM presentation were established. Conclusion. Awareness of clinical presentation of IM is most important for correct diagnosis. Ultrasound biomicroscopy is a useful diagnostic procedure in the following up of IM