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How Should We Manage a Patient With Uveal Melanoma? FREE

Stuart L. Fine, MD
Arch Ophthalmol. 1985;103(7):910-911. doi:10.1001/archopht.1985.01050070036025
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For approximately 100 years, enucleation has been the standard treatment for uveal melanoma.1 It has been assumed that removing the cancer soon after diagnosis would prolong the patient's life. In the 1960s, the urgency to enucleate was suppressed somewhat by a report that up to 20% of eyes removed for suspected melanoma did not harbor a melanoma.2 In the 1970s, when Zimmerman et al3 and Zimmerman and McLean4 proposed that enucleation increased mortality by promoting micrometastases during surgery, the desirability of prompt enucleation was seriously questioned. About this same time, several investigators began to experiment with so-called conservative forms of treatment that allowed the patient with a melanoma to retain the affected eye. While conservative management includes radiation, photocoagulation, and eye wall resection, among others, radiation therapy has been evaluated most extensively.

See also pp 916 and 924.

The two types of radiation treatment are brachytherapy

REFERENCES

Duke-Elder S, Perkins ES: System of Ophthalmology: Diseases of the Uveal Tract . St Louis, CV Mosby Co, 1966;, vol 9.
Ferry AP:  Lesions mistaken for malignant melanoma of the posterior uvea . Arch Ophthalmol 1964;;72:463-469.
Zimmerman LE, McLean IW, Foster WD:  Does enucleation of the eye containing a malignant melanoma prevent or accelerate the dissemination of tumour cells? Br J Ophthalmol 1978;;62:420-425.
Zimmerman LE, McLean IW:  An evaluation of enucleation in the management of uveal melanomas . Am J Ophthalmol 1979;; 87:741-760.
Shields JA, Augsberger JJ, Grady LW, et al:  Cobalt plaque therapy of posterior uveal melanomas . Ophthalmology 1982;; 89:1201-1207.
Gragoudas ES, Goitein M, Verhey L, et al:  Proton beam irradiation of uveal melanomas: Results of a 5½-year study . Arch Ophthalmol 1982;;100:928-934.
Char DH, Saunders W, Castro JR, et al:  Helium ion therapy for choroidal melanoma . Ophthalmology 1983;;90:1219-1225.
Augsberger JJ, Shields JA, Sardi VF, et al: Cobalt plaque treatment of ocular melanoma. Read before the annual meeting, American Academy of Ophthalmology, Atlanta, Nov 14, 1984.
Gragoudas ES: Proton beam irradiation of uveal melanomas. Read before the annual meeting, American Academy of Ophthalmology, Atlanta, Nov 14, 1984.
Seddon JM, Gragoudas ES, Albert DM, et al:  Comparison of survival rates for patients with uveal melanoma after treatment with proton beam irradiation or enucleation . Am J Ophthalmol 1985;;99:282-290.
Gass JDM:  Comparison of prognosis after enucleation vs cobalt 60 irradiation of melanomas . Arch Ophthalmol 1985;; 103:916-923.
Seddon JM, Albert DM, Lavin PT, et al:  A prognostic factor study of disease-free interval and survival following enucleation for uveal melanoma . Arch Ophthalmol 1983;;101:1894-1899.
Gass JDM:  Comparison of uveal melanoma growth rates with mitotic index and mortality . Arch Ophthalmol 1985;;103:924-931.

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Duke-Elder S, Perkins ES: System of Ophthalmology: Diseases of the Uveal Tract . St Louis, CV Mosby Co, 1966;, vol 9.
Ferry AP:  Lesions mistaken for malignant melanoma of the posterior uvea . Arch Ophthalmol 1964;;72:463-469.
Zimmerman LE, McLean IW, Foster WD:  Does enucleation of the eye containing a malignant melanoma prevent or accelerate the dissemination of tumour cells? Br J Ophthalmol 1978;;62:420-425.
Zimmerman LE, McLean IW:  An evaluation of enucleation in the management of uveal melanomas . Am J Ophthalmol 1979;; 87:741-760.
Shields JA, Augsberger JJ, Grady LW, et al:  Cobalt plaque therapy of posterior uveal melanomas . Ophthalmology 1982;; 89:1201-1207.
Gragoudas ES, Goitein M, Verhey L, et al:  Proton beam irradiation of uveal melanomas: Results of a 5½-year study . Arch Ophthalmol 1982;;100:928-934.
Char DH, Saunders W, Castro JR, et al:  Helium ion therapy for choroidal melanoma . Ophthalmology 1983;;90:1219-1225.
Augsberger JJ, Shields JA, Sardi VF, et al: Cobalt plaque treatment of ocular melanoma. Read before the annual meeting, American Academy of Ophthalmology, Atlanta, Nov 14, 1984.
Gragoudas ES: Proton beam irradiation of uveal melanomas. Read before the annual meeting, American Academy of Ophthalmology, Atlanta, Nov 14, 1984.
Seddon JM, Gragoudas ES, Albert DM, et al:  Comparison of survival rates for patients with uveal melanoma after treatment with proton beam irradiation or enucleation . Am J Ophthalmol 1985;;99:282-290.
Gass JDM:  Comparison of prognosis after enucleation vs cobalt 60 irradiation of melanomas . Arch Ophthalmol 1985;; 103:916-923.
Seddon JM, Albert DM, Lavin PT, et al:  A prognostic factor study of disease-free interval and survival following enucleation for uveal melanoma . Arch Ophthalmol 1983;;101:1894-1899.
Gass JDM:  Comparison of uveal melanoma growth rates with mitotic index and mortality . Arch Ophthalmol 1985;;103:924-931.

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