Malignant melanoma of the uvea: diagnosis, characterization and prognosis

Purpose To summarize available data on uveal melanoma biology, diagnosis and clinical characterization. Methods Herein, we review diagnostic criteria, clinical characterization and therapeutic implications of the emerging molecular biology in posterior uveal melanoma/high risk indeterminate choroidal pigmented lesion. Results The diagnosis of uveal melanoma is based on clinical examination with indirect ophthalmoscope and ultrasonograpy. The use of mnemonic "to find small ocular melanoma" is useful in risk stratification of small indeterminate melanocytic choroidal lesions. The use of optical choerence tomograpy and autofluorescence also help in identifying sub-retinal fluid and orange pigment. In the cytogenetic era, tumor-sampling procedures are becoming the main prognostic tools for uveal melanoma patients. Conclusion Ophthalmic oncology is moving in the same direction as all other oncologic subspecialties, starting to determine the patient’s risk using sampling-based laboratory techniques. However, it is essential to start treating patients earlier (in the premalignant tumor stage) and to develop consistent, selective and effective adjuvant therapy