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S. Khan, P. T. Finger, P. Sankull, S. Seregard, D. Gologorsky, T. Murray, T. Kivela, S. Eskelin, R. Raut, C. Corriveau; Clinical and Pathologic Characteristics of Biopsy Proven Iris Melanomas: Results of a Multicenter International Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3808.
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To pool patient data from multiple centers to identify epidemiologic, clinical and pathologic characteristics of malignant melanoma of the iris (MMI).
An internet-based program (Science StudyTrax, Florida) was created to allow for multicenter, international, online data entry. Multiple physician-authors at 5 centers from 4 countries performed retrospective chart reviews on patients with MMI. Specific outcome measures included: demographics, tumor characteristics, related ocular and angle abnormalities, 7th annual AJCC-UICC tumor staging, management options and outcomes.
Seventy-one patients from 5 centers were identified. 43 patients were female (63%). Mean age at diagnosis was 60 and median initial visual acuity was 20/20 (range 20/16 - 20/200). Majority were blue-eyed (n=48, 70%). Tumor color was coded brown (n=38, 53%), amelanotic (n=11,15%) and multicolored (n=7, 10%). Location noted as diffuse (n=3), multifocal (n=46, 65%). Mean number of clock hours involved was 1.9. Median central meridian at 5 o’clock. Mean largest clinical and ultrasonographic diameter was 5.1 mm. Mean UBM thickness was 2.0 mm (range 0 - 8.3mm). Intrinsic tumor vessels present in n=35 (51%) and an iris feeder vessel in (n=5) 7%. Tumors were multifocal (91%), irregular surfaced 55%, with correctopia 25%. Ultrasonographic angle blunting noted in 50%, iris root disinsertion 16%, and IPE displacement in 12%. Clinical presentation included (n=2, 3%) with AC inflammation, hyphema (n=2, 3%), glaucoma (n=13, 19%) and (n=5, 7%) with sectoral cataracts. Clinical TNM staging showed the majority (40%) of tumors classified were T1a (Limited to the iris- not more than 3 clock hours in size). Histologic grade was most spindle cell type (64%), mixed (12%), epithelioid in 4% and 20% had unidentified grading.
This study presents results from the first multicenter, international internet-based study in ophthalmic oncology. We utilized a standard tumor grading system, pool data and extract information on a rare tumor. Bio-informatic cooperative studies allows ophthalmic oncology study larger and more significant numbers of rare tumors.
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