Management of uveal tumors

Purpose In this presentation, we will overview the management of uveal tumours, focussing on melanomas, metastases, lymphomas and haemangiomas. Methods As with other diseases, proper management relies on full systemic and ocular assessment. Accurate measurement of tumour dimensions is especially important. Trans‐retinal or trans‐scleral biopsy may be needed for diagnosis or to grade the degree of malignancy. Uveal melanomas can be treated by: radiotherapy, delivered with plaque, proton beam or stereotactic methods; local resection, performed trans‐retinally or trans‐sclerally; phototherapy using a diode laser, with or without a photodynamic agent; and enucleation. Metastases and lymphomas usually respond to external beam radiotherapy. Haemangiomas resolve after one or two sessions of photodynamic therapy. Prognostication is important, especially in the case of melanoma and this requires both histology and cytogenetics. It is essential to address psychological issues to improve well‐being as much as possible. Results Outcomes are measured in terms of vision, local tumour control, ocular conservation, survival and quality of life. Such results are more meaningful if analyzed according to clinical, histological and cytogenetic baseline variables, depending on the underlying condition. Pathological studies are especially important and require a a specialized pathologist, with good facilities and the support of a highly‐skilled team. Conclusion The management of patients with uveal tumour requires access to a wide range of therapeutic modalities, close collaboration with the pathologist, the support of a multidisciplinary team, and an infrastructure for performing continuous outcomes analyses and research.