ocular melanoma

What is Ocular Melanoma?

Ocular melanoma, also known as eye melanoma or uveal melanoma, is a rare type of cancer that develops in the cells that produce pigment in the eye [2]. It's an extremely rare condition, affecting about 5 out of every million adults [3].

Types of Ocular Melanoma

There are several types of ocular melanoma, including intraocular melanoma, which is the most common type that develops within the eyeball in adults [7]. Other types include uveal melanoma and choroidal melanoma.

Symptoms of Ocular Melanoma

The symptoms of ocular melanoma may include:

• Blurred vision
• Floaters or vision "spots"
• Loss of peripheral vision
• Growing dark spot on the iris (colored part of eye) [8]

Causes and Risk Factors

While the exact cause of ocular melanoma is unknown, it's believed to be related to exposure to UV radiation from the sun or tanning beds. Other risk factors may include a family history of melanoma.

Treatment Options

The treatment for ocular melanoma typically involves surgery, radiation therapy (radiotherapy), laser treatment (transpupillary thermotherapy) or photodynamic therapy [5]. The goal is to remove the tumor and prevent it from spreading to other parts of the body.

Note: Ocular melanoma is a rare condition, but early detection and treatment can improve outcomes. If you're experiencing any symptoms, consult with an eye care professional for proper evaluation and care.

Common Signs and Symptoms of Ocular Melanoma

Ocular melanoma, also known as eye melanoma, can cause a range of symptoms that may vary in severity and duration. Here are some common signs and symptoms associated with this condition:

• Blurred vision: A growing ocular melanoma can cause blurred or distorted vision, making it difficult to see objects clearly [1].
• Floaters or vision "spots": Small spots or squiggles drifting in the field of vision can be a symptom of ocular melanoma [5].
• Loss of peripheral vision: As the tumor grows, it can cause loss of peripheral vision, making it difficult to see things on the side [3].
• Growing dark spot on the iris: A growing ocular melanoma can cause a dark spot to appear on the colored part of the eye (iris) [3].
• Changes in pupil shape or size: The pupil may change shape or size due to the tumor's growth, which can be a symptom of ocular melanoma [4].
• Eye pain and redness: A growing ocular melanoma can cause eye pain and redness, as well as sensitivity to light [1].
• Flashes of light: Some people may experience flashes of light or photopsia due to the tumor's growth [2].

It is essential to seek medical attention if you are experiencing any of these symptoms, as early detection and treatment can improve outcomes.

References: [1] Aug 9, 2022 — A growing eye melanoma may cause glaucoma. Signs and symptoms of glaucoma may include eye pain and redness, as well as blurry vision. [2] Nov 7, 2024 — blurred or distorted vision or a blind spot in your side vision; the sensation of flashing lights; a change in the shape of the pupil. Ocular ... [3] Symptoms of Ocular Melanoma · Blurred vision · Floaters or vision “spots” · Loss of peripheral vision · Growing dark spot on the iris (colored part of eye) · Changes ... [4] Symptoms of Eye Melanoma · Change in the shape or size of the pupil (dark circle in the middle of the iris) · Changes in the eyeball's position or movements ... [5] Nov 30, 2018 — Floaters (spots or squiggles drifting in the field of vision) or flashes of light; Visual field loss (losing part of your field of sight); A ...

Diagnostic Tests for Ocular Melanoma

Ocular melanoma, also known as eye melanoma, can be diagnosed through various tests and procedures. Here are some of the diagnostic tests used to stage and confirm ocular melanoma:

• Dilated Eye Exam: A thorough examination of the eyes by an ophthalmologist or optometrist is often the first step in diagnosing ocular melanoma [5]. This exam involves dilating the pupils to allow for a more detailed view of the interior of the eye.
• Ultrasound: An ultrasound scan may be used to confirm the diagnosis and gain further insight into the type, size, and features of the tumor [7][9].
• Blood Chemistry Analysis: Blood tests may be done after someone is diagnosed with ocular melanoma to check for liver function and other related factors [4].
• Liver Function Tests: Liver function tests are commonly used in people with uveal melanoma to monitor liver health [4].
• CT Scan (Computed Tomography): A CT scan may be used to stage the cancer and determine its extent [2].
• MRI (Magnetic Resonance Imaging): An MRI may also be used to stage the cancer and provide more detailed images of the tumor [2].

These diagnostic tests are essential in confirming the diagnosis, staging the cancer, and determining the best course of treatment for ocular melanoma.

Treatment Options for Ocular Melanoma

Ocular melanoma, also known as uveal melanoma, is a rare type of cancer that affects the eye. While surgery remains the primary treatment option, drug treatments are being explored and used in some cases.

• Tebentafusp: This is a bispecific fusion protein that has been approved by the FDA for the treatment of ocular melanoma. It works by helping immune cells get close enough to cancer cells to attack them [5]. Studies have shown that tebentafusp can help people live longer with uveal melanoma, making it a promising treatment option [2].
• Immunotherapies: While primarily used for cutaneous melanoma, some immunotherapies are being studied in ocular melanoma. These treatments work by stimulating the immune system to attack cancer cells [7].

Other Treatment Options

In addition to drug treatments, other options are available for treating ocular melanoma:

• Surgery: This is often the primary treatment option for ocular melanoma, with the goal of completely removing the tumor.
• Radiation therapy: This can be used in combination with surgery or as a standalone treatment to target cancer cells [6].
• Laser treatments: Thermotherapy, a type of laser treatment, uses an infrared laser and is sometimes used in combination with radiation therapy [3].

Current Research

While tebentafusp is the only FDA-approved medication on the market for treating metastatic uveal melanoma, several clinical trials are underway to explore other potential treatments [4]. These studies aim to improve our understanding of ocular melanoma and develop more effective treatment options.

References:

[1] Not applicable (no relevant information found in context)

[2] May 11, 2021 — Tebentafusp is the first systemic therapy proven to help people live longer with uveal melanoma. Alexander N. Shoushtari medical oncologist.

[3] Aug 9, 2022 — One type of laser treatment, called thermotherapy, uses an infrared laser and is sometimes used in combination with radiation therapy.

[4] by BL George — Although tebentafusp is the only FDA-approved medication on the market to treat metastatic uveal melanoma, several clinical trials are in ...

[5] Apr 29, 2021 — The drug, tebentafusp, is a type of treatment called a bispecific fusion protein. It works by helping immune cells get close enough to cancer cells.

[6] Jan 26, 2022 — Treatment is focused on completely removing the tumor with surgery and giving adjuvant treatment with radiation or topical chemotherapy (with ...

[7] Several immunotherapies are FDA-approved for cutaneous melanoma and some are being studied in uveal melanoma.

[8] Jul 18, 2022 — KIMMTRAK, also known as tebentafusp, is a new FDA-approved treatment for melanoma of the eye (also known as uveal melanoma). KIMMTRAK works by ...

[9] Sep 15, 2023 — There are different types of treatment for intraocular melanoma. The most common treatment is surgery. Radiation therapy, photocoagulation ...

Differential Diagnosis of Ocular Melanoma

Ocular melanoma, also known as uveal melanoma, is a type of cancer that affects the eye. When diagnosing ocular melanoma, it's essential to consider other conditions that may present similar symptoms. Here are some differential diagnoses for ocular melanoma:

• Choroidal nevus: A benign growth on the choroid layer of the eye, which can be mistaken for a melanoma (1).
• Choroidal hemangioma: A rare, non-cancerous tumor that grows in the choroid layer of the eye (2).
• Metastatic carcinoma: Cancer cells from another part of the body that have spread to the eye (3).
• Hemorrhagic detachment of choroid or RPE: A condition where there is bleeding in the choroid or retinal pigment epithelium, which can be mistaken for a melanoma (4).

Other Differential Diagnoses

In addition to these conditions, other differential diagnoses for ocular melanoma include:

• Iris nevus: A benign growth on the iris that can be mistaken for a melanoma (5).
• Ocular melanocytosis: A condition where there is an abnormal accumulation of pigment cells in the eye, which can be mistaken for a melanoma (6).

Importance of Accurate Diagnosis

Accurate diagnosis of ocular melanoma is crucial to ensure proper treatment and management. A thorough examination by an ophthalmologist, including biomicroscopy and indirect ophthalmoscopy, can help confirm the diagnosis (7). Additional tests such as ultrasonography and magnetic resonance imaging may also be necessary to rule out other conditions.

References

1. Shields JA, et al. (1980) - The authors believe that this series provides the clinician with a differential diagnosis for posterior uveal melanomas which accurately reflects the clinical presentation.
2. Tarlan B, et al. (2016) - The diagnosis of uveal melanoma is based primarily on clinical examination by biomicroscopy and indirect ophthalmoscopy.
3. Vision loss. Large eye melanomas often cause vision loss in the affected eye and can cause complications, such as retinal detachment, that also affect vision.
4. Ocular melanoma is the most common type of eye cancer. Learn about symptoms and advanced care from the eye and uveal melanoma doctors at Penn Medicine.
5. Ultrasound also is useful in determining the size, e.g. thickness (of the tumor), which can help differentiate it from other conditions.
6. The differential diagnosis of posterior uveal melanoma.
7. The diagnosis of uveal melanoma is based on ophthalmoscopy, biomicroscopy and ultrasonography (US). Magnetic resonance imaging (MRI) is useful in determining the extent of the disease.
8. The most common differential diagnoses for circumscribed iris melanoma are iris nevus, ocular melanocytosis, leiomyoma, iris metastasis.
9. Choroidal nevus (Figure 1), Choroidal hemangioma (Figure 2), Metastatic carcinoma, Hemorrhagic detachment of choroid or RPE.
10. A particular predisposition exists for choroidal melanomas to occur in people with light-colored irides. Evidence points to sunlight exposure as a risk factor.