Ocular Oncology Yesterday And Today

Uveal Melanoma (UM) is the most common primary malignant intraocular tumor in adults, with a high risk of distant metastases, primarily to the liver, occurring in over 50% of cases often years after initial treatment. Diagnosis relies on detailed eye examinations and imaging techniques like ultrasonography and optical coherence tomography. Historically, enucleation was the standard treatment, but now radiotherapy, including brachytherapy with Ruthenium-106 or Iodine-125 and external beam therapies like proton therapy, is more common. The effectiveness of primary tumor treatment is high (over 90%), but treating distant metastases remains challenging. Surgical methods for liver metastases offer limited survival benefits and are applicable to few patients. Current standard therapies for skin melanoma are less effective for ocular melanoma, but tebentafusp, a drug dependent on HLA-A expression, is the first to extend patient survival.