Uveal melanoma: Diagnosis, classification and management

Uveal melanoma (UM) is the most common primary intraocular malignancy in adults. It arises from melanocytes in the choroid, ciliary body and, less frequently, iris, and affects mainly light-skinned individuals in their sixth decade of life. Diagnosis of UM is often based on clinical examination, including slit lamp biomicroscopy, and ancillary studies, especially ultrasound. Biopsy is rarely required for diagnosis, but performed in selected cases for prognostication. In clinical practice, in addition to anatomical location, UM is routinely classified according to tumor dimensions, with large tumors (>8 mm in height) known to be associated with significantly higher chances for distant metastatic spread and death. Most UM cases are treated conservatively by means of plaque or proton beam radiotherapy, resulting with high tumor control rate, but also compromised vision due to late radiotherapy related complications.