Intraocular melanoma is a type of cancer that affects the eye and can lead to vision loss or even blindness if left untreated. While it is a rare condition, it is important to understand the different treatment options available to those who are diagnosed with it. This article will explore the various treatments for intraocular melanoma, including surgery and radiation therapy.
Introduction
Intraocular or uveal melanoma is severe cancer that forms inside the eye. Although this cancer is not as common as skin cancer, it is life-threatening. This cancer usually affects the middle of the eye, called the uvea, between the sclera and retina. It can form in any part of the uvea, namely –
- · Iris – the colored part of the eye,
- · Ciliary body – ring of muscle fibers behind the iris,
- · Choroid – tissue with blood vessels that bring oxygen and nutrients to the eye.
This melanoma’s most common site of origin is the Choroid, followed by the ciliary body and the iris. It can metastasize to other parts of the body but often doesn’t show any signs and symptoms in the patients. If present, the symptoms are primarily non-specific but can be recognized by a primary eye care specialist. Read more
This melanoma’s most common site of origin is the Choroid, followed by the ciliary body and the iris. It can metastasize to other parts of the body but often doesn’t show any signs and symptoms in the patients. If present, the symptoms are primarily non-specific but can be recognized by a primary eye care specialist. Read more Retinoblastoma: Causes, Symptoms, and Treatment
Causes
The exact etiology behind intraocular melanoma remains unknown. It is believed that changes in the DNA of healthy eye cells can prompt subsequent abnormal proliferation. Accumulation of such mutated cells over some time in the eye may result in intraocular melanoma. Some of the common risk factors that increase the risk of developing intraocular melanoma are:
- Light eye color – People with blue or green eyes are more likely to get melanoma.
- Being white – White people or those with fair complexion are more susceptible when compared to people of other races.
- Age – People between 70 and 80 are at a higher risk.
- Inherited skin disorders – Dysplastic nevus syndrome increases the risk of developing skin and eye melanoma. People with ocular melanocytosis also come under the high-risk category as they have increased pigmentation in the uvea.
- UV light – Long-term exposure to UV light from the sun or tanning beds increases the risk.
- Family history – A family history of intraocular melanoma may also contribute to developing this melanoma.
Symptoms of Intraocular Melanoma
The symptoms of intraocular melanoma do not appear when the tumor is small. However, when the tumor grows more prominent, the following symptoms are seen:
- Blurry vision or sudden Loss of vision
- Soreness in the eye
- Bulging in the eye (uncommon)
- Flashes or “floaters” in the vision
- The dark spot in the iris
- Displaced eye lens
- Double vision
- Eye pain
- Retinal detachment
- Change in the shape of the pupil.
- Change in the way the eye moves or looks.
- Loss of peripheral vision
Screening tests
The diagnosis begins with a general physical examination enabling the ophthalmologist to understand the symptoms better. A detailed eye exam is conducted to rule out other possible health conditions. During the exam, the physician uses an ophthalmoscope (special scope with light) to look at the inside of the eye. The eye doctor often diagnoses intraocular melanoma by examining the eye. But additional screening tests are usually recommended for confirmation of intraocular melanoma. These include:
- Computed tomography (CT) scan uses X-rays to create detailed cross-sectional images of the eye, especially the uveal tract and retina.
- Eye ultrasound: High-frequency sound waves are used to produce images of the eye, and the distance from the cornea to the retina is measured.
- Angiogram: A colored dye injected intravenously and travels to the eyes via the blood vessels. Flash pictures of the blood vessels in and around the tumor are taken using a special camera every few seconds. Usually, a green dye (indocyanine green) is injected into the blood vessel of the arm for this purpose. It helps in identifying areas in the eye that are blocked or leaking.
- Biopsy: In this procedure, a thin needle removes a small sample of the abnormal tissue from the tumor. A pathologist then examines it. This helps to distinguish the type of tumor cells present in the malignancy.
Treatment of Intraocular Melanoma
A small eye melanoma does not require immediate treatment. If the melanoma isn’t growing, the physician often waits for the melanoma to grow before proceeding with any treatment. However, if the melanoma is causing obvious signs and complications, it is treated by the following approaches:
- Surgery – Surgery is the most common treatment method for this melanoma. Resection, enucleation (removal of the eye and part of the optic nerve), and exenteration (removal of the eye, eyelid, muscles, nerves, and fat in the eye socket) are the major surgical procedures adopted while treating uveal melanoma.
- Radiation therapy – High-powered beams such as gamma rays or protons kill cancer cells. It is delivered to the tumor by placing a radioactive plaque directly over the tumor in the eye.
- Laser treatment – Infrared laser can kill melanoma cells in specific situations. It can also be used in combination with radiation therapy.
- Transpupillary thermotherapy – Heat is used to destroy the cells or shrink the tumor cells.
- Photocoagulation – In this procedure, light destroys the blood vessels that bring nutrients to the tumor, thereby causing the tumor to die. When it is used to treat small tumors, it is called light coagulation.
In addition to surgery and radiation therapy, there are other treatment options available for intraocular melanoma. These include thermotherapy, which uses heat to destroy cancer cells, and photodynamic therapy, which uses a special light and a photosensitizing drug to kill cancer cells. In some cases, a combination of treatments may be used to effectively treat the cancer. It is important to discuss all treatment options with your doctor to determine the best course of action for your individual case.
Choosing the Right Treatment Plan for You.
When it comes to intraocular melanoma, there is no one-size-fits-all treatment plan. The best course of action will depend on a variety of factors, including the size and location of the tumor, as well as the patient’s overall health and preferences. It is important to work closely with your doctor to understand all of the available treatment options and to choose the one that is right for you. Don’t be afraid to ask questions and seek a second opinion if necessary.
Overview
Intraocular melanoma is a type of cancer that develops in the cells of the eye. It is a rare condition, but it can be very serious if left untreated. The cancer can spread to other parts of the body, including the liver, lungs, and bones. It is important to understand the symptoms of intraocular melanoma and to seek medical attention if you experience any of them. Symptoms may include blurred vision, a dark spot on the iris, or changes in the shape or size of the pupil. Treatment options for intraocular melanoma include surgery, radiation therapy, and other specialized treatments.
