Titre du document / Document title

Delays in the diagnosis of uveal melanoma and effect on treatment

Auteur(s) / Author(s)

AH-FAT F. G. ⁽¹⁾ ; DAMATO B. E. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, ROYAUME-UNI

Résumé / Abstract

Purpose To investigate the mode of presentation of uveal melanomas, delays in their diagnosis and the effect of delayed diagnosis on treatment outcome. Methods An analysis was carried out of 50 consecutive patients undergoing treatment for uveal melanoma at the Ocular Oncology Service in Liverpool. The mode of presentation of the tumour, onset of symptoms and subsequent management were determined by interview at the time of treatment. Results Seventy-two per cent of patients had one or more symptoms directly attributable to the tumour. These included blurred vision (36%), photopsia (22%), visual field loss (16%), floaters (4%) and metamorphopsia (4%). Forty-two per cent of patients experienced delays in the diagnosis and treatment due to misdiagnoses such as macular degeneration and naevus or due to the lesion being missed at the initial visit. Patients who had experienced delays in diagnosis received treatment after a mean of 6.6 months compared with 4.2 weeks for those who did not experience any delay (p = 0.003). Such patients were more likely to be treated by enucleation (52% vs 17%, p = 0.008) than by an eye-conserving method such as radiotherapy or trans-scleral local resection. Conclusions The primary aim of treatment of uveal melanoma is to reduce the risk of death from metastases and a secondary aim is to conserve the eye with as much vision as possible. This study identifies common reasons for delays in the diagnosis of uveal melanoma. While the effect of early treatment on survival remains controversial, this study shows that patients who have their tumours diagnosed promptly are more likely to be treated by an eye-conserving method than by enucleation.

Revue / Journal Title

Eye   ISSN 0950-222X   CODEN EYEEEC 

Source / Source

1998, vol. 12 (5), pp. 781-782 (9 ref.)

Langue / Language

Anglais

Editeur / Publisher

Nature Publishing Group, Basingstoke, ROYAUME-UNI  (1987) (Revue)

Mots-clés anglais / English Keywords

Malignant melanoma ; Uvea ; Diagnosis ; Time lag ; Treatment ; Prognosis ; Human ; Malignant tumor ; Eye disease ; Uvea disease ;

Mots-clés français / French Keywords

Mélanome malin ; Uvée ; Diagnostic ; Délai ; Traitement ; Pronostic ; Homme ; Tumeur maligne ; Oeil pathologie ; Uvée pathologie ;

Mots-clés espagnols / Spanish Keywords

Melanoma maligno ; Uvea ; Diagnóstico ; Plazo ; Tratamiento ; Pronóstico ; Hombre ; Tumor maligno ; Ojo patología ; Uvea patología ;

Localisation / Location

INIST-CNRS, Cote INIST : 21076, 35400007129878.0040