Observation in choroidal melanomas

Abstract

Abstract Purpose The management of suspected small choroidal melanomas is controversial. The purpose of the present study is to assess tumor growth, visual acuity changes, activity factors and survival on choroidal melanoma patients under observation in our Intraocular Tumors Unit. Methods Prospective, consecutive and non‐interventional case series. Patients diagnosed with choroidal melanoma from 1990 to 2010 and with observation as therapeutic option were included. Criteria for observation were small size without risk factors for growing; medium and large size: no risk factors for growing (but size), advanced age, bad general health, only eye or treatment rejection. Demographic, tumoral and follow‐up data were collected in a data base and analyzed. Results 118 out of 397 patients (29.7%) diagnosed with uveal melanoma were enrolled, with mean age of 66.4 years (SD 14.3). The mean follow‐up time was 51.1 months (SD 4.5). Regarding the size, 91 (77.1%) tumors were small and 85 (72.%) were diagnosed in a routine examination. Main reason for observation was tumor small/inactive (80,5%) followed by treatment rejection (17.7%). Mean height was 2.8mm (SD 1.9) and mean base 7.6 (SD 2.8). Along the follow‐up, 17 tumors grew; 11 were treated with brachytherapy, 5 with enucleation and one with brachytherapy and enucleation. Only 16 patients died during the follow‐up, 2 by melanoma metastasis. Conclusion In our series with more than 4 years of follow up, observation seems to be a safe therapeutic option for selected small choroidal melanomas, allowing the patients to preserve visual function.