Using risk factors for detection and prognostication of uveal melanoma
The early detection of malignancy, particularly uveal melanoma, is crucial in protecting visual acuity, salvaging the eye, and preventing metastasis. Risk factors for early detection of uveal melanoma have been clearly delineated in the literature and allow identification of melanoma when it is tiny...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2015-01-01
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| Series: | Indian Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2015;volume=63;issue=2;spage=110;epage=116;aulast=Rishi |
| _version_ | 1828463871953731584 |
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| author | Pukhraj Rishi Vikram V Koundanya Carol L Shields |
| author_facet | Pukhraj Rishi Vikram V Koundanya Carol L Shields |
| author_sort | Pukhraj Rishi |
| collection | DOAJ |
| description | The early detection of malignancy, particularly uveal melanoma, is crucial in protecting visual acuity, salvaging the eye, and preventing metastasis. Risk factors for early detection of uveal melanoma have been clearly delineated in the literature and allow identification of melanoma when it is tiny and simulates a nevus. These factors include thickness >2 mm, presence of subretinal fluid (SRF), symptoms, the orange pigment, margin near optic disc, acoustic hollowness, surrounding halo, and absence of drusen. The importance of early detection is realized when one considers melanoma thickness, as each millimeter increase in melanoma thickness imparts 5% increased risk for metastatic disease. Newer imaging modalities like enhanced depth imaging optical coherence tomography and fundus autoflouroscence facilitate in detection of SRF and orange pigment. Additional molecular biomarkers and cytological features have been identified which can predict the clinical behavior of a small melanocytic lesion. Features that suggest a poor prognosis include higher blood levels of tyrosinase m-RNA, vascular endothelial growth factor, insulin-like growth factor; monosomy 3 and gains in chromosome 8. Management of uveal melanoma includes enucleation (for large), local eye wall resection, brachytherapy, charged particle irradiation, and thermotherapy (for small to medium tumors). Although the role of a good clinical evaluation cannot be underestimated, it is advisable to evaluate the various radiological, molecular, and cytological features, to enhance the accuracy of early diagnosis and improved prognosis. |
| first_indexed | 2024-12-11T03:01:27Z |
| format | Article |
| id | doaj.art-08f31c5df242454aaf2238db2e7543da |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-12-11T03:01:27Z |
| publishDate | 2015-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-08f31c5df242454aaf2238db2e7543da2022-12-22T01:23:02ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892015-01-0163211011610.4103/0301-4738.154373Using risk factors for detection and prognostication of uveal melanomaPukhraj RishiVikram V KoundanyaCarol L ShieldsThe early detection of malignancy, particularly uveal melanoma, is crucial in protecting visual acuity, salvaging the eye, and preventing metastasis. Risk factors for early detection of uveal melanoma have been clearly delineated in the literature and allow identification of melanoma when it is tiny and simulates a nevus. These factors include thickness >2 mm, presence of subretinal fluid (SRF), symptoms, the orange pigment, margin near optic disc, acoustic hollowness, surrounding halo, and absence of drusen. The importance of early detection is realized when one considers melanoma thickness, as each millimeter increase in melanoma thickness imparts 5% increased risk for metastatic disease. Newer imaging modalities like enhanced depth imaging optical coherence tomography and fundus autoflouroscence facilitate in detection of SRF and orange pigment. Additional molecular biomarkers and cytological features have been identified which can predict the clinical behavior of a small melanocytic lesion. Features that suggest a poor prognosis include higher blood levels of tyrosinase m-RNA, vascular endothelial growth factor, insulin-like growth factor; monosomy 3 and gains in chromosome 8. Management of uveal melanoma includes enucleation (for large), local eye wall resection, brachytherapy, charged particle irradiation, and thermotherapy (for small to medium tumors). Although the role of a good clinical evaluation cannot be underestimated, it is advisable to evaluate the various radiological, molecular, and cytological features, to enhance the accuracy of early diagnosis and improved prognosis.http://www.ijo.in/article.asp?issn=0301-4738;year=2015;volume=63;issue=2;spage=110;epage=116;aulast=RishiCiliary bodychoroideyeirismelanomametastasisprognosistumoruveaChemotherapyintravitreal chemotherapyintra-arterial chemotherapyintravenous chemotherapyperiocular chemotherapyretinoblastomaSubtenon′s chemotherapytreatmentAutoflouroscenceenhanced depth imagingeyegene expression profilingmalignancymetastasismonosomy 3nevusoptical coherence tomographytumoruveal melanoma |
| spellingShingle | Pukhraj Rishi Vikram V Koundanya Carol L Shields Using risk factors for detection and prognostication of uveal melanoma Indian Journal of Ophthalmology Ciliary body choroid eye iris melanoma metastasis prognosis tumor uvea Chemotherapy intravitreal chemotherapy intra-arterial chemotherapy intravenous chemotherapy periocular chemotherapy retinoblastoma Subtenon′s chemotherapy treatment Autoflouroscence enhanced depth imaging eye gene expression profiling malignancy metastasis monosomy 3 nevus optical coherence tomography tumor uveal melanoma |
| title | Using risk factors for detection and prognostication of uveal melanoma |
| title_full | Using risk factors for detection and prognostication of uveal melanoma |
| title_fullStr | Using risk factors for detection and prognostication of uveal melanoma |
| title_full_unstemmed | Using risk factors for detection and prognostication of uveal melanoma |
| title_short | Using risk factors for detection and prognostication of uveal melanoma |
| title_sort | using risk factors for detection and prognostication of uveal melanoma |
| topic | Ciliary body choroid eye iris melanoma metastasis prognosis tumor uvea Chemotherapy intravitreal chemotherapy intra-arterial chemotherapy intravenous chemotherapy periocular chemotherapy retinoblastoma Subtenon′s chemotherapy treatment Autoflouroscence enhanced depth imaging eye gene expression profiling malignancy metastasis monosomy 3 nevus optical coherence tomography tumor uveal melanoma |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2015;volume=63;issue=2;spage=110;epage=116;aulast=Rishi |
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