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Enzo A. Fulco, Sr., Carol L. Shields, Swathi Kaliki, Sanket U. Shah, Wenjuan Luo, Minoru Furuta, Jerry A. Shields; Iris Melanoma Features And Prognosis In Children And Adults In 317 Patients. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3385.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate clinical features and prognosis of iris melanoma in children versus adults.
Retrospective study of 317 patients.
Of 8101 eyes with uveal melanoma, there were 317 (4%) with iris melanoma, including 24 (8%) children (<20 years), 187 (59%) mid-adults (21-60 years), and 106 (33%) older adults (>60 years). Based on age (young, mid-adults, older adults), there was no difference in patient race, gender, tumor quadrant, thickness, pigmentation, associated corectopia, ectropion uveae, hyphema, and extraocular extension. Significant differences based on age were found with mean tumor basal diameter (5.6, 5.9, 6.8 mm) (p=0.0464), tapioca appearance (17%, 2%, 3%) (p=0.0015), mean intraocular pressure (19, 19, 23 mm Hg) (p=0.0062), secondary glaucoma (26%, 29%, 47%) (p=0.0083), tumor seeding in angle (17%, 25%, 38%) (p=0.0320), and mean number of clock hours of angle seeding (1, 1, 3) (p=0.0230). Multivariate analysis of factors predictive of metastasis included extraocular extension (p=0.0037) and high intraocular pressure (p=0.0032). Factors predictive of death included increased tumor thickness (p=0.0470), and high intraocular pressure (p=0.0446). Tumor-related metastasis and death [Kaplan-Meier] at 5, 10, and 20 years were 5.2%, 8.8%, and 11.3% and 2.2%, 3.3%, and 6.0%, respectively.
Clinical presentation of iris melanoma is significantly different in children with smaller tumor size, less tumor seeding in angle, and less incidence of secondary glaucoma compared to adults. The rate of metastasis and death in children versus adults was not statistically significant in this study.
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