Review article

Uveal melanoma: clinical features and diagnostic procedures

Snježana Kaštelan orcid.org/0000-0002-3983-1157 ; Department of Ophthalmology, University Hospital Dubrava, Zagreb, Croatia
Antonela Gverović Antunica ; Department of Ophthalmology, General Hospital Dubrovnik, Dubrovnik, Croatia
Lidija Beketić-Orešković ; Department of Clinical Oncology, School of Medicine, University of Zagreb, Zagreb, Croatia; Department of Radiotherapy and Internal Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Ivana Bakija ; Psychiatric Hospital “Sv. Ivan”, Zagreb, Croatia
Marija Bogadi ; Psychiatric Hospital for children and adolescents, Zagreb, Croatia

Abstract

Uveal melanoma is the most common primary intraocular malignancy in adults and the eye is the second most common site for primary melanoma after the skin. Early recognition is important in protecting visual acuity, saving the eye and preventing metastasis. Signs for early detection of uveal melanoma when it simulates a nevus include thickness >2 mm, presence of subretinal fluid, symptoms, orange pigment, margin of the tumour near the optic disc, acoustic hollowness, surrounding halo, and the absence of drusen. This is essential considering that each millimetre increase in melanoma thickness imparts a 5% increased risk for metastatic disease. Delays or inability to make an accurate and early diagnosis may have grave consequences. Methods of diagnosis have substantially improved, although clinical diagnosis remains the standard method in the eyes with clear media. In eyes with opaque media ultrasound is the most useful ancillary diagnostic technique. Newer imaging modalities such as optical coherence tomography and fundus autofl ouroscence facilitate in detection of subretinal fluid and orange pigment. Additional molecular biomarkers and cytological features which can predict the clinical behaviour of a small melanocytic lesion have been identifi ed. Although the role of a good clinical evaluation cannot be underestimated, it is advisable to assess the various radiological, molecular and cytological features in order to enhance the accuracy of early diagnosis and improvement in the patients’ prognosis.

Keywords

uveal melanoma; pathogenesis; clinical features; diagnostic procedures

Hrčak ID:

192226

URI

https://hrcak.srce.hr/192226

Publication date:

21.12.2017.

Article data in other languages: croatian

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