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Management of uveal tumours
Author(s) -
DAMATO B
Publication year - 2009
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2009.1362.x
Subject(s) - medicine , enucleation , radiation therapy , choroid , grading (engineering) , malignancy , uvea , biopsy , external beam radiotherapy , radiology , surgery , eye disease , pathology , retina , brachytherapy , physics , civil engineering , optics , engineering
Purpose The purpose of this presentation is to describe the management of uveal melanomas and the other most common uveal tumours. Methods Choroidal melanomas are treated with plaque radiotherapy if possible, with proton beam radiotherapy, stereotactic radiotherapy, trans‐scleral local resection, trans‐retinal endoresection, phototherapy and enucleation being reserved for patients who cannot be managed with a plaque. Increasingly, tumour biopsy is performed for histological grading of malignancy and for cytogenetic studies aimed at determining the genomic tumour type so that risk of metastatic disease can be determined. Choroidal metastases usually respond to external beam radiotherapy. Biopsy may be needed to confirm the diagnosis. Choroidal haemangiomas are treated by photodynamic therapy, with good response in most patients. Results In the large majority of patients, it is possible to conserve the eye and vision. Patients need life‐long follow‐up in case tumour recurrence occurs. After radiotherapy of choroidal and ciliary body melanomas some patients develop exudative and neovascular complications needing treatment. Conclusion Successful management of uveal tumours is based on a firm diagnosis, accurate staging of disease, reliable prognostication and adequate aftercare.