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Uveal Melanoma Treatment

Eye-preserving local therapy and emerging systemic options for the most common adult ocular cancer

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Uveal Melanoma Treatment?

Uveal melanoma is a malignancy of pigment-producing cells of the eye. It is usually detected on routine ophthalmic examination as a pigmented choroidal mass with associated retinal detachment, visual disturbance, or photopsia. Genetic profiling of the primary tumor with chromosome 3 status and BAP1 mutation defines metastatic risk.

Local control is achieved with plaque brachytherapy using iodine-125 or ruthenium-106, proton beam radiation, or enucleation for very large tumors. Liver is the dominant metastatic site, and surveillance with hepatic imaging is lifelong because relapse can occur a decade after primary treatment.

Metastatic disease has historically responded poorly to chemotherapy and to checkpoint inhibitors used in cutaneous melanoma. Tebentafusp, an HLA-A*02:01-restricted bispecific T-cell engager targeting glycoprotein 100, is the first agent to show overall survival benefit in this setting.

Symptoms

Painless visual blurring or photopsia
Visual field defect or floater perception
Pigmented mass on ophthalmoscopic examination
Retinal detachment overlying a choroidal lesion
Iris heterochromia or sentinel episcleral vessels

Risk Factors

Light eye color and fair complexion
Ocular or oculodermal melanocytosis
Dysplastic nevus syndrome
Chronic solar exposure of the eye
Germline BAP1 tumor predisposition syndrome

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When new flashes, floaters, or visual changes appear
  • When a pigmented eye lesion is noted on examination
  • When a known nevus shows growth or symptoms
  • When unexplained liver test elevation occurs after diagnosis
  • When BAP1 family history suggests germline risk

Treatment Methods

01
Plaque brachytherapy or proton beam for primary tumor
02
Enucleation for very large or refractory disease
03
Genetic profiling for metastatic risk stratification
04
Liver-focused surveillance imaging every six months
05
Tebentafusp for HLA-A*02:01 positive metastatic disease
06
Liver-directed therapy with radioembolization or chemosaturation
07
Multidisciplinary review with ocular oncology and medical oncology

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.