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Follow‐up: which one and for whom?
Author(s) -
Damato B.
Publication year - 2016
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.1755-3768.2016.0101
Subject(s) - medicine , scope (computer science) , intensive care medicine , presentation (obstetrics) , scope of practice , disease , systemic therapy , case presentation , surgery , cancer , health care , computer science , economics , programming language , economic growth , breast cancer
Summary In theory, surveillance of patients with uveal melanoma is aimed at detecting and treating ocular recurrence and morbidity as well as systemic metastases. In practice, the scope of such follow‐up is uncertain and controversial. Regular examination by an ocular oncologist can be difficult for patients who live far from the oncology center whereas inexpert ophthalmologists close to the patient's home may fail to detect tumor recurrence and other ocular morbidity in a timely manner. Screening for metastatic disease is expensive, can expose patients to harmful ionizing radiation, and only rarely seems to result in prolongation of life. Follow up protocols also have psychological impacts on patients, both positive and negative. There is scope for evidence‐based guidelines, which at present are lacking. The aims of this presentation are to consider the benefits and costs of ocular and systemic surveillance and to propose suggestions for personalized care.