Outcome Measures of New Technologies in Uveal Melanoma Review from the European Vision Institute Special Interest Focus Group Meeting

Uveal melanoma UM is the most common primary intraocular tumor in adults. New diagnostic procedures and basic science discoveries continue to change our patient management paradigms. A recent meeting of the European Vision Institute EVI special interest focus group was held on Outcome Measures of New Technologies in Uveal Melanoma, addressing the latest advances in UM, starting with genetic developments, then moving on to imaging and treatment of the primary tumor, as well as to investigating the most recent developments in treating metastases, and eventually taking care of the patient s well being. This review highlights the meeting s presentations in the context of the published literatur

Proton beam radiotherapy of diffuse iris melanoma in 54 patients

Background Treatment modalities in iris melanoma include excision, plaque radiotherapy, photon or proton beam therapy and enucleation. In extensive tumours and diffuse seeding, radiotherapy remains as an alternative to enucleation. Methods This study is a retrospective, consecutive, interventional, single institutional case series. 54 patients with a diffuse and non resectable iris melanoma diagnosed from September 1998 to June 2012 were included. A 68 megaelectron volt proton beam was used to treat the anterior segment with a total dose of 4 12.5 cobalt grey equivalent. The cases were evaluated for local tumour control, eye retention, functional outcome and local complications after treatment. Results During a mean follow up of 62.7 amp; 8197;months median 54.8 amp; 8197;months, range 5.5 159.6 amp; 8197;months , local tumour control was achieved in 96.3 of the patients. Cataract and glaucoma were the main complications developing after irradiation in 42.6 and 55.6 , respectively. In 34 of 44 patients 77.3 who underwent cataract removal, a visual acuity of 20 40 or better following surgery was preserved. Enucleation was performed in three patients. The reason was suspected tumour recurrence in one and glaucoma in two. Hepatic metastasis occurred in one patient. Conclusions As an alternative to enucleation, whole anterior segment fractionated proton beam radiotherapy offered excellent local tumour control in diffuse iris melanoma. Given the limited alternatives, the rate of complications appears acceptable and visual function could be preserved in the majority of the patients during follow up