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| {{CMG}}{{AE}}{{Simrat}} | | {{CMG}}{{AE}}{{Simrat}} |
| ==Overview== | | ==Overview== |
| Secondary prevention strategies following uveal melanoma include [strategy 1], [strategy 2], and [strategy 3].
| | There are no established measures for the [[secondary prevention]] of uveal melanoma. |
| | ==Secondary Prevention== |
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| ==Secondary Prevention==
| | *There are no established measures for the [[secondary prevention]] of uveal melanoma. |
| Currently, there is no consensus regarding type or frequency of scans following diagnosis and treatment of the primary eye tumor. Of the 50% of patients who develop metastatic disease, more than 90% of patients will develop liver metastases. As such, the majority of surveillance techniques are focused on the liver. These include abdominal magnetic resonance imaging (MRI), abdominal ultrasound and liver function tests.
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| Regardless of treatment, monitoring for metastasis should be performed regularly and patient compliance with follow-up should be stressed. Regular dilated fundus examination, liver function test, and CT or right upper quadrant ultrasound assessing liver metastasis is the follow-up performed by most ophthalmologists. The frequency of follow-up is recommended to be based on the demonstrated risk of the tumor, as discussed below, with visits every 3-4 months suggested for patient’s with the highest risk tumors. Uveal melanoma metastases may present years after the primary tumour has
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| been treated. A patient who receives treatment (e.g. brachytherapy, EBRT, or enucleation) can still get metastases from the tumour cells that escaped from
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| the eye to the body PRIOR to treatment.Almost 50% of patients with uveal melanoma will develop metastases within 15 years of being initially diagnosed.
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| 2% of patients at the time of initial uveal melanoma diagnosis would show an evidence of metastases. A diagnosis of uveal melanoma metastasis has a very poor
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| prognosis and, unfortunately, has a high rate of mortality. There are several approaches to surveillance for metastases. Because metastases
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| usually occur in the liver and in the lung, tests that are performed are focused on these organs. These tests are performed every 6-12 months and can continue for
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| many years or decades. However, there are no standard guidelines or approachesfor surveillance as there is no clear consensus amongst experts.
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| • Blood tests – to determine how the liver is functioning.
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| • Imaging tests – ultrasound to monitor the liver and a chest X-ray to monitor the lung. Some people receive Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scans.
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| • Physical exam – to detect issues.
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| • Recently, gene studies, by a needle biopsy from the tumour before treatment, can predict with high accuracy the potential to develop metastases eventually.
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| == References == | | == References == |
| {{Reflist|2}} | | {{reflist|2}} |
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| | [[Category:Disease]] |
| | [[Category:Ophthalmology]] |
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| | [[Category:Ophthalmology]] |