Is Ocular Melanoma Fatal & How Aggressive Is It?

Ocular melanoma is a type of eye cancer that develops in the pigment-producing cells of the eye. It accounts for 5% of all melanomas. It is more common in males than in females.(1) In most cases, it appears as secondary cancer after skin cancer. Its exact causes are not known. It is represented by the appearance of lumps in the eyes that appears as dark spots in the vision. Its symptoms include blurred vision, peripheral vision, and many more. Its risk factors involve old age, exposure of the UV light, overexposure to sunlight, white skin, and many more. It can be diagnosed by routine eye examination, ultrasound of the eyes, fluorescein angiogram, and sometimes tumor biopsy.

Is Ocular Melanoma Fatal & How Aggressive Is It?

Like skin melanoma, there are fewer research studies that can describe ocular melanoma. It is less understood and is considered a silent killer. In most of the cases, it originates from the pigmented cells of the choroid. However, it can also affect Iris and Ciliary body. It is also categorized as uveal melanoma because it may also develop from the uvea, a layer between the retina and white of the eye.(2)

Ocular melanoma is an aggressive form of cancer that develops in any three parts of the eye, iris, ciliary body, or choroid. It can grow in all three parts at a time. These three areas are collectively called the uvea or uveal tract. Most of the cases of uveal tract melanomas start from the choroid, less commonly from the ciliary body and the iris. Ocular melanoma can develop in any combination of the three. However, Iris melanomas show the best prognosis, and ciliary melanoma shows the worst.(3)

Ocular melanoma is aggressive as it has a higher risk of metastasis. It depends on the size of the tumor, the involvement of the ciliary body, orange pigmentation on the tumor, and the old age of the patient. Moreover, the tumor staging system is not utilized for this cancer. It spreads to other parts of the body through blood, very rarely through lymph nodes or lymphatic system.(3)

Ocular melanoma tumors originate from the pigment cells known as melanocytes that render color to the eye. Its occurrence is quite rare as compared to other cancers. Its exact causes are not known. Exposure to ultraviolet rays from the sun or artificial sunbeds may increase the risk of developing skin melanoma. This risk increases in people with fair skin, fair or red hair, and blue or grey or green eyes. Skin melanoma elevates the risk of ocular melanoma.(3)

Ocular melanoma is commonly seen in people who have atypical mole syndrome, which is also known as dysplastic nevus syndrome. People with this condition have a relatively higher risk of developing melanoma in the skin, which is marked by more than 100 moles on their body. These moles are often abnormal in size and shape.(3)

The incidences of ocular melanoma are diagnosed in approximately 2,500 adults every year. Its cause is not found, but it is observed that its incidence is highest among people who have lighter skin and blue eyes.

Approximately 50% of patients with ocular melanoma are likely to develop metastases in 10 to 15 years after its diagnosis. A small percentage of people may take 20-25 years after their initial diagnosis to develop metastases. Its metastatic nature shows it is a fatal disease. In most cases, it has a 50% mortality rate, which is not changed despite effective and modern treatment procedures employed for treating the primary eye tumor.(2)

Conclusion

Though ocular melanoma is rare cancer, it can affect various parts of the eye. It is an aggressive and fatal type of cancer as it can metastasize to multiple other parts of the body. Some of its cases have 50% mortality rates despite adequate treatment.

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