Uveal Melanoma

Ireland may have the highest incidence of uveal melanoma in Europe and possibly the world, the 2016 Irish College of Ophthalmologists Annual Conference in Killarney, Ireland, heard. Caroline Baily MRCSI (Ophth), MRCGP, DO, FEBO, Specialist Registrar in Ophthalmology, Royal Victoria Eye and Ear Hospital (RVEEH), Dublin, Ireland, presented the findings of the first study on the epidemiology of uveal melanoma in Ireland at the conference. The observational study included 259 eyes in patients referred to the RVEEH, the national tertiary centre for ocular melanoma, from 2010 to 2015. Prior to 2010, Irish uveal melanoma patients were referred to Liverpool, UK, for treatment. The study found that the age-adjusted incidence of uveal melanoma in Ireland ranged from 11.5 (2014) to 17.2 (2012) cases per million of population. “When compared with previously published data we have the highest incidence in Europe and the US, however it is worth noting that these studies are old and may not reflect current incidence figures in Europe,” Dr Baily told EuroTimes. “It is possible we have one of the highest incidences of uveal melanoma in the world. This is a difficult thing to state, but based on the data we have, it is certainly a possibility. However, we would need updated epidemiological data across Europe to fully determine this,” she added.

SYSTEMIC TREATMENTS

Treatments modalities during the course of the study included brachytherapy (63.7 per cent), enucleation of the affected eye (27 per cent) and proton beam radiation (9.2 per cent). Chromosome 3 loss and chromosome 8q gain were identified in 29.3 per cent and 29.7 per cent of cases, respectively. Dr Baily noted that uveal melanoma survival rates are good in Ireland — one-year survival was 95.8 per cent and four-year survival was 84.0 per cent in the study patient population. “Despite the different treatment options available, overall survival in uveal melanoma has not improved. Ultimately we need the development of systemic treatments to improve overall survival rates,” Dr Baily said.

CILIARY BODY

Uveal melanoma is the most common primary intraocular malignancy in adults, and involves the iris, ciliary body, or choroid. Despite this, it is still a very rare disease, Dr Baily noted. “With the national diabetic screening service now available (in Ireland), it is likely there will be an increased pick-up of incidental melanomas, due to the large volume of posterior segments being reviewed,” she told EuroTimes. Uveal melanoma is often asymptomatic and therefore picked up during routine eye examinations, Dr Baily noted.