Articles about Eye Health and Disease 2001
 

Two Different Treatment Techniques for Treating Ocular Choroidal Melanoma Result in the Same Mortality Rate.

(From the Collaborative Ocular Melanoma Study Group. Arch Ophthal 2001;119:951-965.)

 Melanoma is a tumor which can originate in the choroid of the eye, which is a vascular layer beneath the retina.  It occurs most commonly in Caucasians, and like melanomas of the skin, can be associated with metastasis (spread) to distant areas of the body, and death.  There has been controversy over the best method to preserve both life and vision in cases with melanoma.  One option is removal of the eye (enucleation).  Another option is a radiation treatment called "brachytherapy".  In this treatment, a plaque containing radioactive iodine is sutured to the wall of the eye over the site of the tumor.  This treatment can allow some preservation of vision in the eye.

In this 16 year multicenter, randomized clinical trial, 1317 patients with medium sized choroidal melanomas were treated either with enucleation or brachytherapy.  The 5-year survival rates were nearly identical between the two treatments, with an 81% survival rate for those treated with enucleation, and an 82% survival rate for those treated with brachytherapy.  In about 90% of cases, some vision was retained following brachytherapy.  Of the enucleated eyes, an incorrect diagnosis of melanoma was found in only 2 of 660 eyes (examined by microscope after the eye was removed), indicating an excellent ability to correctly diagnose the tumor.

Ten-year data will further indicate whether one treatment or the other leads to better survival.  Also, it was noted that certain tumors were excluded from the study, such as those that touch the optic nerve or those near the ciliary body in the front part of the eye.

 

Return to the Eye News Index of Articles Page