Eye Treatment For Ocular Melanoma – 2020 updated

Updated on - Written by
Medically reviewed by Kimberly Langdon, MD

Ocular Melanoma

Ocular melanoma, which is also known as uveal melanoma,  cancer located in a part of the eye and surrounding tissues.

Cancer forms in different types. Melanoma is a malignant tumor. Uncontrolled proliferation of cells that produce pigment called melanocytes is the main cause of it

Uveal melanoma[1] is a common primary type of cancer in adults, however, melanoma in the eye alone is rare. Your chance of getting that is about 6[2]per million. People with this condition have a greater risk of developing melanoma of the skin.

What is ocular melanoma?

Uveal melanoma is similar to other skin cancers in the way they spread. Most of the time, eye melanomas spread from the innermost layer of skin. That innermost layer is the basal layer, the part of the skin with the lowest concentration of blood vessels. 

We see most of these common cancers in part of the eye such as near the temples, lower eyelid, and between the eyebrows, it typically receives more exposure to ultraviolet UV and people whose skin burns easily such as fair skin.

Melanoma usually begins in melanocytes in the choroid or posterior uvea, a duct at the back of the eye through which healthy blood supplies flow.

To date, there are very little number of research for Uveal Melanoma and there have been no specific therapies for it. The incidence of uveal melanoma has remained stable over the past years. It represents a larger percentage than non-cutaneous skin cancer[3] among men aged 15–44 years (35%)

Ocular melanoma is quite rare with no known cause. Current data indicate[1] that uveal melanoma occurs more commonly in those over 65 years of age and patients with a history of other skin or eye cancers.

Dysplastic nevus syndrome also is also atypical mole syndrome is at greater risk of developing melanoma.

Other key clinical data of Ocular Melanoma Foundation indicate that less than half of diagnosis have been screened by a physician. 

Symptoms of Ocular Melanoma

As the condition is a rare one, the symptoms[1] tend to develop gradually. People with melanoma of the eye typically notice these common symptoms over some time.

 Some of the most common primary symptoms of melanoma include: 

  • Small circular spots that may bleed
  • Red or white spots on the surface of your skin
  • Blurry vision
  • Faint lines or streaks under your eyes
  • Permanent color changes in your skin, which may range from a pinkish color to dark purple
  • Redness or lumpiness on your neck that is uneven or crooked
  • Eye pain 
  • Irregular eye movements 
  • Constricted pupil 
  • Eye changes that occur over time, such as crusting or oozing around the edges of the eyelid 
  • Redness in the eye 

See a doctor if any of these symptoms persist and a medical examination reveals that an eyelid lesion has developed.

Diagnosis Of Ocular Melanoma

It is vital to ensure timely diagnosis of ocular melanoma

When diagnosing eye cancer, it is essential to distinguish between ocular melanoma and other types of melanoma. A specialist must be the one who make reference to Ocular melanoma.

One of the first tests that most people undergo is called ophthalmoscopy[4], which uses a particular scope for an in-depth view of the eye. Another test uses a small lens and light to examine the inside of the back of the eye, while another test examines the iris (colored part of the eye), cornea, lens, and ciliary body which change the shape of the lens.

If a doctor suspects that melanoma is present in the eye, they should do more tests, such as:

Ultrasound

Ultrasound[5] delivers sound waves to visualize abnormalities for quick diagnosis. They help the eye doctor identify the exact location of the growth or tumor in the eye. Ultrasound scans can also detect cancers of the retina and white of the eye or optic nerve. 

Fluorescein angiography

Fluorescein angiography[6] is a diagnostic technique use to monitor the presence of the blood vessel (vein) at the tumor. The colored fluorescent dye in the blood vessel reflects different colors in the tumor (reddish in syngeneic tumors). Next, The image processing center receives it and converts to electrical signals for the image analysis process.

This is considerably simpler than most imaging modalities to fit in around a busy surgical schedule. The catheter is capable of circulating multiple dye molecules at a time, so the obtain of complete image of the target lesion can be obtained from each scan in only five minutes, versus 10-15 minutes for a similar scan using traditional imaging methods.

Optical coherence tomography

(OCT)[7] is a diagnostic medical imaging modality that has been used to image the retina and dura mater, but has now found new applications including intracranial investigation. 

The image-guided spatial mapping procedure combines the subretinal monitoring and OCT modalities in an improved integrated surgical method to enable intraoperative diagnosis and surgical intervention.

The earlier the melanoma is usually diagnosed, the better it is likely to be treated. The life expectancy of ocular melanoma is a 90 percent survival rate[8] over 5 years when caught early. If melanoma has not spread to the lymph nodes, then almost half of the people have a long life expectancy, although this number is lower for those with lymph node metastases.

melanoma blood test

Ocular Melanoma

Dr. Stark of QIMR Berghofer conducted a progressive research study to develop panel biomarkers that its utilization is to to detect skin melanoma.

The research aim to collect blood samples from people with either melanoma in the back of their eyes or benign nevi. In addition to this, it also includes a small percentage of metastasizing cases.

Using a panel of microRNA biomarkers to differentiate the stages of the disease from tested samples

“After some development, blood tests had the potential to be used as a monitoring tool in conjunction with optometrists, specialists, general practitioners”, says Dr. Stark.

“If someone went to their optometrist for a regular check-up and find a mole, you could have this blood test at each routine visit to help monitor mole changes,” he said.

The discovery of an early warning sign of melanoma is in increasing blood biomarkers 

This will also help to closely monitor a high-risk patient that has the potential to have the cancer spread.

melanoma biopsy

Biopsy[9] procedures are not commonly done to diagnose uveal melanoma. However, it can provide information about whether or not it may spread

Biopsies take a portion of the growth that is examined to determine cell type, among other characteristics.

Your ophthalmologist may refer you to another specialist to do more assessment exams to determine whether or not the melanoma has spread (metastasized).

Treatment for Ocular Melanoma

Ocular Melanoma

The eye is a place of many nerve endings, meaning that treatment may involve the use of drugs or other techniques. If the melanomas are near the optic nerve, then removing cancer cells from the eye may be difficult.

Doctors can remove melanoma near the eye with a fine blade, and if they are unsure about whether it is uveal melanoma, they may recommend a biopsy first.

Generally, options fall into two categories, cures for uveal melanoma may include radiation and surgery.

Ocular melanoma surgery

Surgery removes the tumor cells and some healthy tissue that surrounds the eye. The success of surgery depends on the type of melanoma within the eye, its size, and location.

Surgical treatment for uveal melanoma may include removal of the iris and some of the surrounding tissue, or removal of the entire eye.

Laser Photocoagulation

Laser photocoagulation is when the laser zaps the cancerous part of the iris until it dies. Laser photocoagulation is a better option for patients with smaller choroidal melanoma.

Ocular melanoma radiation

Different types of radiation therapy are used to destroy the ocular melanoma and prevent it from metastasizing.

Plaque radiation therapy is a common[10] procedure for ocular melanoma. This method uses radioactive seeds, causing a localized area of diffuse damage that helps destroy the cancer cells and prevent further growth. 

Depending on the circumstances of each case, this treatment occurs after complete surgical excision of the eye.

Home remedies for ocular melanoma

Some home remedies for ocular melanomas may help to ease any discomfort people may feel.

Home remedies for eye discomfort:

  • Applying cool compresses to the eye.
  • Applying ice packs to the eye may relieve pain and inflammation.
  • Using an ice pack on the eye for 10 minutes or so at a time.
  • Using soothing ointments.
  • Taking NSAIDs.
  • Using a humidifier to improve air circulation.
  • Using a salve or ointment.

Conclusion 

Health professionals can treat and prevent threats of ocular melanoma by early diagnosis. However, most patients are treated to remove tumor cells from the optic nerve itself, which requires months (or years) of treatment with anti-tumor agents.

Many times there are no visible signs of melanomas. So how do you detect it? You should look for spots on the light in your field of vision.

Eye cancer has a 90% rate of survival if they are caught early, and treatment occurs early. However, as the disease progresses it can cause increased signs and symptoms Especially if you have not had regular eye exams.

Frequently Asked Questions

What is primary eye melanoma?

Primary also known as choroidal melanoma cancer begins in the eye and develops inside the pigment-generating cells that provide color to the eyes.

Is melanoma common in conjunctiva?

Eye melanoma is difficult to detect by looking only in the mirror, but it can also form in your conjunctiva.

Can choroidal melanoma be prevented?

To date, it has not been well studied and there are no specific screening methods to detect it.

What causes ocular melanoma?

Most of these cancer cells are seen in part of the eye such as near the temples, lower eyelid, and between the eyebrows, it typically receives more exposure to ultraviolet UV and people with fair skin.

Can doctors use chemotherapy as a treatment?

Because there are few treatment options for ocular melanoma, and the cancer is usually slow-growing, doctors usually recommend a regimen of chemotherapy.

What are the side effects of radiation therapy?

The amount of radiation that a person receives will depend on several factors, including the type of tumor and how many tumor cells are found in the area being treated.
Side effects can include: headaches, nausea, difficulty sleeping, hot flashes, increased blood pressure, and shortness of breath, extremely dry skin, and unusual hair loss.

What are the complications of treatments may cause?

If the cancer is found in the middle of the eye, doctors may remove the eye. More serious complications occur including bleeding, large scarring or rashes, and rare cases of blindness.
 


+ 10 sources

Health Canal avoids using tertiary references. We have strict sourcing guidelines and rely on peer-reviewed studies, academic researches from medical associations and institutions. To ensure the accuracy of articles in Health Canal, you can read more about the editorial process here

  1. Predrag Jovanovic, Marija Mihajlovic, Jasmina Djordjevic, Slobodan Vlajkovic, Sonja Cekic, Vladislav Stefanovic. (2013). Ocular melanoma: an overview of the current status. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693189/
  2. S Kaliki & C L Shields. (2017). Uveal melanoma: relatively rare but deadly cancer. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5306463/
  3. Natalie H. Matthews, Wen-Qing Li, Abrar A. Qureshi, Martin A. Weinstock & Eunyoung Cho. (2020). Epidemiology of Melanoma. Available from: https://www.ncbi.nlm.nih.gov/books/NBK481862/
  4. Lucas Holderegger Ricci & Caroline Amaral Ferraz. (2017). Ophthalmoscopy simulation: advances in training and practice for medical students and young ophthalmologists. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482210/
  5. Alexander L. Klibanov & John A. Hossack. (2015). Ultrasound in Radiology: from Anatomic, Functional, Molecular Imaging to Drug Delivery and Image-Guided Therapy. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4580624/
  6. Cavallerano. (1996). Ophthalmic fluorescein angiography. Available from: https://pubmed.ncbi.nlm.nih.gov/8963072/
  7. Vicktoria Vishnevskaya-Dai, Dinah Zur, Shiran Yaacobi, Iris Moroz, Hadas Newman & Meira Neudorfer. (2016). Optical Coherence Tomography: An Adjunctive Tool for Differentiating between Choroidal Melanoma and Metastasis. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779843/
  8. Eshini Perera, Neiraja Gnaneswaran, Ross Jennens & Rodney Sinclair. (2014). Malignant Melanoma. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934490/
  9. Luisa Frizziero, Edoardo Midena, Sara Trainiti, Davide Londei, Laura Bonaldi, Silvia Bini & Raffaele Parrozzani. (2019). Uveal Melanoma Biopsy: A Review. Available from:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721328/
  10. C Stannard, Sauerwein, G Maree & K Lecuona. (2012). Radiotherapy for ocular tumours. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3574242/

Written by:

Healthcanal Staff

Medically reviewed by:

HealthCanal Editorial team is a team of high standard writers, who qualified the strict entrance test of Health Canal. The team involves in both topic researching and writting, which are under supervision and controlled by medical doctors of medical team.

PubMed Central

Database From National Institute Of Health

U.S National Library of Medicine
Go to source