CURRENT CLINICAL MANAGEMENT OPTIONS FOR UVEAL MELANOMA

With an annual incidence of 4.9 to 7.6 cases per million people, uveal melanoma is diagnosed in approximately 1500 Americans annually. 14 Historically, once the diagnosis of primary uveal malignant melanoma was established, the eye was enucleated, resulting in a number of eyes with simulating uveal melanoma lesions or benign melanocytic lesions being enucleated. 2,10,22,31 Furthermore, multivariate analysis comparing metastatic rates between patients treated with enucleation versus those treated with radiotherapy showed no statistical significance. As a result, fewer patients are being enucleated, and more are being managed with conservative treatment alternatives. The treatment option elected depends upon factors such as the affected eye's visual acuity and intraocular pressure; the tumor location, size, and growth rate; the patient's age and general health; the psychologic status of the patient; and the status of the fellow eye. 30 With these factors in mind, clinicians currently have a variety of treatments to offer patients, including observation, laser photocoagulation, thermal therapy, radiation, local excision, and enucleation.