Ocular Melanoma

Definition of Ocular Melanoma

Ocular melanoma is the most common cancer of the
eye. It is also the second most common form of
melanoma (a tumor of melanin creating cells), following
cutaneous.

There are three subsets of ocular melanoma

1. Uveal melanoma - Cancer of the back three layers

of the eye
2. Choroidal melanoma - Cancer of the layer of the
blood vessels beneath the retina
3. Conjunctival melanoma - Cancer of the mucous
membrane covering the outer surface of the eye
and is very rare
Above is an image of an eye with ocular melanoma.

Source: http://www.macmillan.org.uk/information-and-support/eye-cancer-ocular-melanoma#260114
Possible Causes of the Cancer
While it is unclear why ocular melanoma occurs, scientists
have determined certain genetic mutations (of which are
described in a later slide) that may contribute. Certain factors
may increase risk, such as:

● Long exposure to sunlight or artificial light (protracted

exposure to UV radiation)
● Possessing lighter-colored eyes
● Old age
● Caucasian descent
● Inheritance of skin conditions
● Abnormal pigmentation of the eyelids and uvea

Source: https://www.aao.org/eye-health/diseases/ocular-melanoma-cause
Above is an image of how UV radiation can distort DNA.
 Description of Symptoms
Symptoms of ocular melanoma are may be nonexistent
in certain victims, but if the victim does show symptoms,
they include:

● Blurred vision
● Seeing flashing lights and shadows where there
are none
● Dark or brown spots on the white part of the eye
● A change in shape of the pupil
● Loss of peripheral vision
Above is an image of a man who shows a symptom of ocular melanoma.
● A frequent sensation of specks of dust in your
sight (floaters)

Sources :http://www.macmillan.org.uk/information-and-support/eye-cancer-ocular-melanoma#260114

http://www.mayoclinic.org/diseases-conditions/eye-melanoma/basics/symptoms/con-20027875
 Stages of Ocular Melanoma

A way to stage ocular melanoma is the TNM system:

● Tumor (How large?)

● Node (Has it spread to the lymph nodes?)
● Metastasis (Has the cancer metastasized to
different bodily parts?)

Depending on these factors, the melanoma is staged

accordingly. There are seven stages.

Source: http://www.cancer.net/cancer-types/eye-cancer/stages-and-grades
Stages of Ocular Melanoma Part 2
To the right is a screenshot from
Cancer.net
(http://www.cancer.net/cancer-types/eye-c
ancer/stages-and-grades)

The numbers and letters refer to

categorizations based upon the TNM
system, and the size categories scale
upwards based upon the thickness and
size of the melanoma.
What the Stages Look Like:
As the stages progress, the melanoma enlarges or
spreads. Below are images of uveal, choroidal, and
conjunctival melanoma (the three types of ocular
melanoma).

Uveal Melanoma Choroidal Melanoma Conjunctival Melanoma

 What Gene is Mutated to Cause Ocular Melanoma
The genes mutated for ocular melanoma appear to be GNAQ and GNA11. These
are rather common mutations, approximately 50% of people have the GNAQ
mutation and approximately 23% have the GNA11 mutation. This does not mean
that these genes are directly responsible, only that they are commonly found in
cases of ocular melanoma.

Source: https://www.melanoma.org/understand-melanoma/what-is-melanoma/ocular-melanoma
Prevention of Ocular Melanoma
Since what exactly causes melanoma of the eye is not entirely known, the only
method to possibly prevent ocular melanoma is to wear sunscreen of a high SPF
rating.
 Diagnosis
For the diagnosis of ocular melanoma, a doctor may
advise:

● Eye exams
● Optic ultrasounds
● Imaging of blood vessels near and within the
tumor (angiography)
● Removing unusual tissue for examination

The image above is one of an optic ultrasound.

Source: http://www.mayoclinic.org/diseases-conditions/eye-melanoma/basics/symptoms/con-20027875
 Treatment
There are two general treatments for ocular melanoma: radiation and surgery.

Radiation Therapy: Powerful radiation (such as x-rays) is used to eradicate the melanoma or keep it from
expanding.

Surgery: Surgery for ocular melanoma depends on the melanoma’s magnitude and position. For small
tumors, surgery usually involves the removement of the tumor and some healthy tissue, while for large
tumors surgery may involve the removement of the entire eye. Once the eye is removed, an implant is
substituted and attached to ocular muscles so the implant may move.

To the right is a woman receiving radiation therapy.

Source: https://www.aao.org/eye-health/diseases/ocular-melanoma-treatment
Side Effects of Treatment
Both treatments may result in damage to the
patient’s vision. In the case of surgery, damage is
almost certain, unless the patient has a small
enough tumor. If a one who suffers from ocular
melanoma has a tumor that is large enough to
warrant the removal of the eye, then evidently the
patient of that surgery will lose sight in that eye.
 Survival Rate for Ocular Melanoma
When the melanoma is confined to the
eye, the 5-year survival rate (the
percentage of people who have survived
at least 5 years) is around 80%. When
the cancer spreads farther through the
body, the 5 year survival rate drops to
around 15%.

Above is a graph of survival probability for each of the stages.

Source: http://www.cancerresearchuk.org/about-cancer/type/eye-cancer/treatment/statistics-and-outlook-for-eye-cancer
 Statistics in the US
● 6 per million people in the United
States get ocular melanoma.
● Ocular melanoma is more common
in men at 6.8 per million in contrast
to the 5.3 per million in women.
● An estimated 3,130 new cancers of
the eye (of which most will be
melanoma) will be diagnosed in
America in 2017.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693189/
https://www.cancer.org/cancer/eye-cancer/about/key-statistics.html Above is an image of choroidal melanoma, a subset of ocular melanoma.
Personal Interest
We chose ocular melanoma because
the eyes are one of the most complex
organs in the body, and how cancer
affects its complexity is interesting.

Above is a diagram of the eye.

 Demographical Prevalence
Throughout the world, ocular melanoma
seems to affect older light-eyed
Caucasian males more often than other
groups.

Above shows a person who is more likely to be diagnosed with ocular melanoma.

https://www.melanoma.org/understand-melanoma/what-is-melanoma/ocular-melanoma