Gamma Knife for Uveal Melanoma

Uveal Melanoma, the Most Common Adult Eye Cancer

Uveal Melanoma: What Is It?

The uvea, the central layer of the eye, is where uveal melanoma, a rare but dangerous type of eye cancer, originates. There are three components to the uvea:

• Iris (the eye’s coloured portion)
• Ciliary body (which regulates the lens’s shape)
• A layer of blood vessels called the choroid provides the eye with nourishment.
• The choroid is where the majority of uveal melanomas start, then the ciliary body, and infrequently, the eye.

The exact causes of uveal melanoma are unknown, however genetic abnormalities, light eye colour, and specific skin disorders may raise risk. This is in contrast to skin melanoma, which is frequently brought on by sun exposure.

Who’s in Danger/ Risk?

• People with light-colored eyes (either green or blue)
• Over 50 years of age
• Pale skin or light complexion
• Melanoma in the family or genetic conditions such as BAP1 tumour predisposition syndrome
• UV radiation exposure might possibly be involved, though research is ongoing to determine this connection.

Signs of Melanoma of the Uvea

Early indications of uveal melanoma are frequently absent. When it develops, the following symptoms could appear:

• Vision distortion or blurriness
• A black patch that is seen on the iris
• Vision floaters or flashes
• Peripheral vision loss
• Eye ache (less frequent)

Even before symptoms show up, routine eye exams can aid in the early detection of uveal melanoma.

How is the diagnosis of uveal melanoma made?

Usually, a combination of the following is used to make the diagnosis:

• Examination of the dilated eye
• Eye ultrasound imaging
• Fluorescein angiography (blood vessel visualisation)
• OCT, or optical coherence tomography
• Fine-needle biopsy may be used in certain situations to confirm the diagnosis.

Options for Uveal Melanoma Treatment

The tumor’s size, position, and extension, as well as the patient’s general health and vision, all influence the course of treatment. Key possibilities consist of:

• One of the most popular treatments is radiation therapy.
• In more severe cases, surgical excision of the tumour or the eye (enucleation)
• Transpupillary thermotherapy, or laser therapy
• A targeted, non-invasive radiation therapy is called Gamma Knife Radiosurgery.

Why Use a Gamma Knife for Melanoma of the Uvea?

For medium-to-large tumours or those in challenging sites where surgery may be dangerous, the Gamma Knife is a successful treatment. Additionally, it is utilised for patients who are not candidates for plaque brachytherapy or conventional surgery, or in cases that repeat frequently.

Gamma Knife Advantages for Uveal Melanoma:

• Painless, outpatient procedure
• No hospitalisation or incision is necessary.
• Few adverse effects only
• Maintains the structure of the eyes
• High tumour local control
• Repeatable if necessary

What Can We Expect While Seeking Treatment?

1. To map the tumour, a thorough MRI or CT scan is conducted.
2. The head can be held still with a stereotactic head frame or mask.
3. In a single session, usually from 30 minutes to several hours, radiation is administered.
4. Patients are followed after treatment and are typically allowed to go home the following day.

Prognosis and Follow-Up

Following therapy, patients need to undergo routine imaging, eye exams, and systemic screening to check for metastases, particularly to the liver, which is the most common location of distribution.
Tumour size, genetic markers (such monosomy 3), and early identification are some of the factors that affect prognosis. Early diagnosis and treatment can greatly increase survival rates.

In conclusion

Although uveal melanoma is an uncommon and dangerous illness, patients now have a higher chance of maintaining their vision and quality of life because to developments in precision therapy like Gamma Knife Radiosurgery. Early detection and effective treatment depend on routine eye exams and symptom awareness.
See a specialist neurosurgeon or ocular oncologist to learn about the safest and most efficient treatment options, such as Gamma Knife, if you or someone you know is experiencing strange changes in vision or has been diagnosed with uveal melanoma.

Source:

1. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/uveal-melanoma
2. https://www.curemelanoma.org/about-melanoma/types/uveal-melanoma
3. https://en.wikipedia.org/wiki/Uveal_melanoma
4. https://www.mayoclinic.org/diseases-conditions/eye-melanoma/symptoms-causes/syc-20372371
5. https://www.nature.com/articles/eye2016275
6. https://www.cancer.gov/types/eye/patient/intraocular-melanoma-treatment-pdq
7. https://pmc.ncbi.nlm.nih.gov/articles/PMC7109381/
8. https://pubmed.ncbi.nlm.nih.gov/33152286/
9. https://journals.lww.com/neur/fulltext/2023/71001/gamma_knife_radiosurgery_for_uveal_melanoma__our.24.aspx
10. https://bjo.bmj.com/content/93/1/40