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Disease Focus:
Conjunctival melanoma
Melanomas of the conjunctiva (the transparent sheath that covers the eyeball and the inner surface of the eyelid) are very rare; occurring in less than one individual per million people every year, most commonly in the Caucasian population. These melanomas usually appear in adulthood with the mean age of incidence being around 60 years. Conjunctival melanomas can appear spontaneously or following the development of intra-epithelial neoplasia, rarely they develop from an already existing mole or naevus.
Melanomas of the conjunctiva (the transparent sheath that covers the eyeball and the inner surface of the eyelid) are very rare; occurring in less than one individual per million people every year, most commonly in the Caucasian population. These melanomas usually appear in adulthood with the mean age of incidence being around 60 years. Conjunctival melanomas can appear spontaneously or following the development of intra-epithelial neoplasia, rarely they develop from an already existing mole or naevus.
Ocular adnexal lymphoma
Ocular adnexa lymphomas (OAL) develop as primary or secondary tumour manifestations in the orbit, conjunctiva, eyelids, and lacrimal glands and drainage system. The pathogenesis of OAL is currently poorly understood.
Ocular adnexa lymphomas (OAL) develop as primary or secondary tumour manifestations in the orbit, conjunctiva, eyelids, and lacrimal glands and drainage system. The pathogenesis of OAL is currently poorly understood.
Uveal melanoma
Melanoma is a cancerous tumour, which grows, invades surrounding tissues and disseminates through the blood to the liver and other parts of the body. Melanoma arises from pigment-filled cells known as melanocytes. In the eye, this tumour develops from melanocytes in a dark tissue known as the uvea.
Our laboratory research into uveal melanoma focusses on the genetic abnormalities that make this cancer behave so aggressively. Our work has already enhanced prognostication, making it possible to foretell the future health of our patients. We hope to gain a better understanding of the genetic regulators of tumour behaviour so that more effective treatment can be developed, thereby prolonging life.
Our clinical research has made it possible to save useful vision in eyes that would previously have been lost and treatment methods we have developed are now being adopted around the world. These include: various methods of local resection of choroidal melanoma; proton beam radiotherapy of iris melanoma; eccentric placement of ruthenium plaque in the treatment of choroidal melanoma; and biopsy of choroidal melanoma.
We are also investigating quality of life in patients with intraocular melanoma so that we can understand how patients react to their disease and its treatment and such insights will help us to anticipate and avert psychological difficulties.
Uveal melanomas become more common with age, mostly becoming apparent at around the age of sixty years. Men and women are affected in equal numbers. These tumours are rare, affecting only about six people per million per year. Most patients come to attention because they noticed blurred vision, flashing lights or gaps in the field of vision. In about a third of patients, the tumour is discovered on routine eye examination.
Risk factors for uveal melanoma include white skin and blue/grey eye colour. Some arise from a mole inside the eye (i.e., 'naevus') or from a birth defect in which the population of melanocytes is abnormally high ('melanocytosis').
The purpose of treating uveal melanomas is to prevent spread of tumour to other parts of the body (i.e., 'metastasis'). Previously, treatment consisted only of ocular amputation (i.e., 'enucleation'). This has now been superseded, whenever possible, by a variety of methods aimed at conserving the eye and useful vision. These so-called 'conservative' therapies include various forms of radiotherapy, laser treatment and local tumour resection.
