Abstract
Purpose: :
To create and introduce an online database for biopsy proven iris melanoma.
Methods: :
A literature search for known epidemiological, clinical, cytopathologic histopathologic, and immunopathologic characteristics as well as AJCC-UICC nomenclature for staging of iris melanomas was used to construct an online database. Planned to include 10 clinical centers, we began enrolling 17 biopsy proven cases of iris melanoma from The New York Eye Cancer Center. StudyTRAX software (Jacksonville, FL) was utilized to streamline study design, data collection and analysis.
Results: :
The mean subject age at time of diagnosis was 61 years (range 42 to 75). All subjects were Caucasian. Six of the subjects were male, 11 were female. Eleven cases involved the right eye, six involved the left. Best corrected initial visual acuity was 20/50 or better in 16 of 17 patients. Iris color was blue in 13, brown in 2, and hazel in 2. Tumor color was heterogeneous in 6(35%) cases, with the most common tumor color being tan(47%), followed by brown(41%), and amelanotic (24%). The mean number of clock hours involved was 2.0(range 0.5 to 12). Ten of the tumors were limited to the inferior half of the iris, 4 were limited to the superior half, and 3 involved both. The mean largest basal diameter was 5.26 mm (SD 2.19) and the initial mean thickness by ultrasound was 1.50 mm (SD 0.70). Other tumor characteristics were ectropion uveae (65%), intrinsic vascularity (29%) and corectopia (59%). Nine of the tumors were found to have angle involvement, with melanomalytic glaucoma present in 2 eyes. Pigment dispersion was found in 9 of 17 eyes. Clinical staging was T1 in 8 cases and T2 in 9, with no patients having lymph node involvement or distant metastases. Management was enucleation (n=1), iridectomy (n=1), and Palladium-103 plaque radiation (n=15).
Conclusions: :
: We have created on online database for registering both patient and tumor related characteristics for biopsy proven cases of iris melanoma. A larger multi-center study (using the StudyTRAX database system) will help us better define the clinical characteristics of iris melanomas, biomarkers for metastasis, and the effects of the tumor and treatment on affected eyes.
Keywords: oncology • tumors • iris