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Time course of diagnosis and treatment of uveal melanomas in a intraocular tumors unit
Author(s) -
VICENTE TIERNO N,
SAORNIL MA,
GARCIAALVAREZ C,
ALMARAZ A,
GIRALDO A,
LOPEZLARA F,
DE FRUTOS J
Publication year - 2010
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.1755-3768.2010.3266.x
Subject(s) - medicine , enucleation , melanoma , ophthalmology , visual acuity , surgery , cancer research
Purpose To analyze the time course of diagnosis and treatment of uveal melanomas in an ocular referral unit in a period of 20 years. Methods Prospectively collected data on consecutive patients diagnosed of uveal melanoma, from 1990 to 2010, were analyzed. Epidemiologic and general data, clinical and tumor characteristics at the time of diagnosis (visual acuity, activity signs, size and location) and treatment were collected in a Microsoft access database. Three periods were established: 1990‐2000, 2000‐2005 and 2005‐2010, in order to compare tumor characteristics and treatment. Statistical analysis was performed by Pearson’s Chi‐square test to compare differences. Results From a total of 378 patients 85 were diagnosed in the first period, 146 in the second, and 146 in the third one. Melanoma was diagnosed in a routine examination in 121 patients and in 248 cases due to the presence of symptoms, with a similar distribution in the three periods, p=0.206. Visual acuity (VA) showed a tendency to decrease along time, VA<=0.1 represented 25.9% of all the cases, being the first period 18.4% and 31% in the third one (p=.009). Tumor size and macular involvement tend to decrease, p<0.05. Activity signs showed no differences along time. The number of patients treated with brachytherapy has increased with 25.9% before 2000, up to 42.1% after 2006 (p=.001), showing a decrease in enucleation from 38.8% to 24.4% (p=.002) Conclusion The diagnosis of uveal melanoma is showing smaller tumors but with worse visual acuity it can not be explained by changes in size, macular involvement or activity signs. The increased conservative treatments are allowing to preserve eye and visual function.