Intraocular Melanoma

Intraocular melanoma is a very rare form of cancer that arises in the melanocytes of the eye. Melanocytes are the cells that produce the melanin, which pigments the skin, hair, and eyes. While melanoma is most commonly located in the skin, it can also occur in the eye, and it most frequently arises in the uvea. The uvea consists of three components: the iris, ciliary body, and choroid, and the choroid is the most frequent site of intraocular melanoma.

Intraocular melanoma is a rare but aggressive type of eye cancer. Early detection, successful treatment, and follow-up are key to controlling the disease. Progress in research continues to enhance results and hold promise for patients. If you experience any symptoms or have risk factors, see an ophthalmologist for a complete evaluation.

The exact cause of intraocular melanoma remains unclear, but several risk factors are associated with its development:

• Genetic Mutations: Certain genetic changes, such as mutations in the GNAQ and GNA11 genes, are often linked to intraocular melanoma.
• Ultraviolet (UV) Light Exposure: Prolonged exposure to UV radiation may increase the risk.
• Light Eye Color: Individuals with light-colored eyes, such as blue or green, have a higher risk.
• Age and Gender: The risk of intraocular melanoma increases with age and is slightly more common in men.
• Family History: A family history of melanoma may increase susceptibility.

Intraocular melanoma often presents without noticeable symptoms in its early stages. However, as the tumor grows, the following symptoms may develop:

• Blurry or distorted vision
• Dark spots on the iris
• Vision loss in one eye
• Flashes of light or floaters (dark spots or lines in vision)
• Change in pupil shape

Diagnosing intraocular melanoma involves a series of tests and examinations, including:

• Comprehensive Eye Exam: A dilated eye examination to check for abnormalities.
• Ultrasound Imaging: High-frequency sound waves create detailed images of the eye’s interior.
• Optical Coherence Tomography (OCT): Provides cross-sectional images of the eye.
• Fluorescein Angiography: A dye is injected into a vein to visualize blood flow in the retina and choroid.
• Biopsy: In rare cases, a tissue sample may be taken for microscopic analysis.

Treatment for intraocular melanoma depends on the tumor’s size, location, and extent. Common treatment options include:

• Radiation Therapy: Brachytherapy (plaque radiation) or external beam radiation targets the tumor while preserving vision.
• Surgery: Enucleation (removal of the eye) may be necessary in advanced cases.
• Laser Therapy: Thermotherapy or laser photocoagulation may be used to shrink smaller tumors.
• Targeted Therapy: Drugs that block specific molecules involved in tumor growth may be effective in some cases.
• Immunotherapy: In clinical trials, immune checkpoint inhibitors are being evaluated for their effectiveness.

While intraocular melanoma cannot be entirely prevented, certain measures may reduce the risk:

• Wear UV-protective sunglasses and hats when outdoors.
• Schedule regular eye exams, especially if you are at higher risk.
• Maintain overall health with a balanced diet and exercise.
• Monitor any changes in your vision and seek prompt medical attention.

The prognosis for intraocular melanoma depends on factors like the tumor size, location, and whether it has metastasized. Early detection and treatment generally lead to better outcomes. Patients whose cancer remains confined to the eye often have a favorable prognosis.

Living with intraocular melanoma can be challenging, but support systems and adaptive strategies can help patients cope. Options include:

• Visual aids and rehabilitation services
• Counseling and support groups
• Regular follow-ups and monitoring
• Maintaining a healthy lifestyle

Ongoing research is exploring innovative treatments for intraocular melanoma, including:

• Gene Therapy: Investigating the role of genetic mutations and targeting them for treatment.
• Immunotherapy: Developing immune checkpoint inhibitors and other immunotherapies.
• Targeted Drug Therapy: Designing drugs that specifically inhibit tumor growth.
• Clinical Trials: Advancing knowledge through experimental treatments and novel approaches.

Patients and families can benefit from support networks and resources such as:

• Cancer support organizations like the American Cancer Society (ACS) or CancerCare.
• Ophthalmic Oncology Centers for specialized treatment and consultations.
• Counseling services for mental and emotional well-being.

Clinical trials play a vital role in developing new treatments. Patients can participate in trials to access emerging therapies. Resources like ClinicalTrials.gov provide comprehensive listings of ongoing trials.