Aim: To assess prevalence and presentation of choroidal melanoma in a hill population of northern India along with its demographics, features, diagnostics, treatment and outcome with comparison to western population. Method: Choroidal melanoma constitutes most common intraocular malignancy with early appearance in Asian population. This is the 1st case series from a hill state of Uttarakhand, northern India involving medium to large size tumour with extraocular extension. In this retrospective study we assessed the prevalence, clinical presentation, diagnostic modalities, treatment plan, disease outcome, prognosis with survival and mortality. The study was carried out in time duration from February 2019- March 2021. Results: Data shows the presence of five patients, four male and 1 female in age range of 47-77 years, with median age at 62 years. Patient presented with visual equity in range of 6/18 to perception of light in time range of six months to 2 years. Fundus examination revealed presence of medium to large size choroidal mass with surface pigmentation and serous detachment. Neovascular glaucoma was present in three patients. Three patients underwent brachytherapy with I 125 and Ru 106, two cases responded well to therapy, one case presented with recurrence of tumour and neovascular glaucoma, underwent preenucleation radiation with external beam radiation therapy (EBRT) and the eye was lost following enucleation. Among five patients three underwent enucleation and thereafter were referred to surgical oncology for enlarged regional and cervical chain of lymph nodes for suspected metastasis. Histopathology via fine needle aspiration cytology (FNAC) or biopsy from whole specimen showed two cases of spindle cell, one of mixed cell variety and two of epitheloid cell type. Two cases of eitheloid cell type and one of spindle cell type needed EBRT as there was extraocular extension. All cases with enucleation were adviced an ocular implant. A diligent post treatment follow was maintained to look out for local recurrence and distant metastasis. Conclusion: Hill states have poor accessibility to healthcare. Our study shows existence of choroidal melanoma may be much larger than anticipated and cases could have been missed, hence making the need for dilated fundus examination a requirement and necessity. Histopathology, serology and imaging are much needed tools for diagnosis and staging of disease along with treatment of choroidal melanoma eventually indicating prognosis, survival and mortality. Treatment modalities as brachytherapy and EBRT are more frequently being used, indicating a shift in treatment more towards organ salvaging and preservation so as to maintain best visual function.
| Published in | International Journal of Ophthalmology & Visual Science (Volume 6, Issue 4) |
| DOI | 10.11648/j.ijovs.20210604.19 |
| Page(s) | 231-246 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Brachytherapy, Choroidal, EBRT, Enucleation, Melanoma, Mortality, PET-scan, Prognosis
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APA Style
Deepesh Arora, Anuj Sharma, Devesh Sharma, Bhavna Tiwari, Abhishek Kumar, et al. (2021). Prevalence of Choroidal Melanoma in a Hill Population of Northern India. International Journal of Ophthalmology & Visual Science, 6(4), 231-246. https://doi.org/10.11648/j.ijovs.20210604.19
ACS Style
Deepesh Arora; Anuj Sharma; Devesh Sharma; Bhavna Tiwari; Abhishek Kumar, et al. Prevalence of Choroidal Melanoma in a Hill Population of Northern India. Int. J. Ophthalmol. Vis. Sci. 2021, 6(4), 231-246. doi: 10.11648/j.ijovs.20210604.19
AMA Style
Deepesh Arora, Anuj Sharma, Devesh Sharma, Bhavna Tiwari, Abhishek Kumar, et al. Prevalence of Choroidal Melanoma in a Hill Population of Northern India. Int J Ophthalmol Vis Sci. 2021;6(4):231-246. doi: 10.11648/j.ijovs.20210604.19
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Download@article{10.11648/j.ijovs.20210604.19,
author = {Deepesh Arora and Anuj Sharma and Devesh Sharma and Bhavna Tiwari and Abhishek Kumar and Kanika Gupta and Rohan Mehra and Abhinav Arora and Dinesh Sharma},
title = {Prevalence of Choroidal Melanoma in a Hill Population of Northern India},
journal = {International Journal of Ophthalmology & Visual Science},
volume = {6},
number = {4},
pages = {231-246},
doi = {10.11648/j.ijovs.20210604.19},
url = {https://doi.org/10.11648/j.ijovs.20210604.19},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20210604.19},
abstract = {Aim: To assess prevalence and presentation of choroidal melanoma in a hill population of northern India along with its demographics, features, diagnostics, treatment and outcome with comparison to western population. Method: Choroidal melanoma constitutes most common intraocular malignancy with early appearance in Asian population. This is the 1st case series from a hill state of Uttarakhand, northern India involving medium to large size tumour with extraocular extension. In this retrospective study we assessed the prevalence, clinical presentation, diagnostic modalities, treatment plan, disease outcome, prognosis with survival and mortality. The study was carried out in time duration from February 2019- March 2021. Results: Data shows the presence of five patients, four male and 1 female in age range of 47-77 years, with median age at 62 years. Patient presented with visual equity in range of 6/18 to perception of light in time range of six months to 2 years. Fundus examination revealed presence of medium to large size choroidal mass with surface pigmentation and serous detachment. Neovascular glaucoma was present in three patients. Three patients underwent brachytherapy with I 125 and Ru 106, two cases responded well to therapy, one case presented with recurrence of tumour and neovascular glaucoma, underwent preenucleation radiation with external beam radiation therapy (EBRT) and the eye was lost following enucleation. Among five patients three underwent enucleation and thereafter were referred to surgical oncology for enlarged regional and cervical chain of lymph nodes for suspected metastasis. Histopathology via fine needle aspiration cytology (FNAC) or biopsy from whole specimen showed two cases of spindle cell, one of mixed cell variety and two of epitheloid cell type. Two cases of eitheloid cell type and one of spindle cell type needed EBRT as there was extraocular extension. All cases with enucleation were adviced an ocular implant. A diligent post treatment follow was maintained to look out for local recurrence and distant metastasis. Conclusion: Hill states have poor accessibility to healthcare. Our study shows existence of choroidal melanoma may be much larger than anticipated and cases could have been missed, hence making the need for dilated fundus examination a requirement and necessity. Histopathology, serology and imaging are much needed tools for diagnosis and staging of disease along with treatment of choroidal melanoma eventually indicating prognosis, survival and mortality. Treatment modalities as brachytherapy and EBRT are more frequently being used, indicating a shift in treatment more towards organ salvaging and preservation so as to maintain best visual function.},
year = {2021}
}
TY - JOUR T1 - Prevalence of Choroidal Melanoma in a Hill Population of Northern India AU - Deepesh Arora AU - Anuj Sharma AU - Devesh Sharma AU - Bhavna Tiwari AU - Abhishek Kumar AU - Kanika Gupta AU - Rohan Mehra AU - Abhinav Arora AU - Dinesh Sharma Y1 - 2021/12/09 PY - 2021 N1 - https://doi.org/10.11648/j.ijovs.20210604.19 DO - 10.11648/j.ijovs.20210604.19 T2 - International Journal of Ophthalmology & Visual Science JF - International Journal of Ophthalmology & Visual Science JO - International Journal of Ophthalmology & Visual Science SP - 231 EP - 246 PB - Science Publishing Group SN - 2637-3858 UR - https://doi.org/10.11648/j.ijovs.20210604.19 AB - Aim: To assess prevalence and presentation of choroidal melanoma in a hill population of northern India along with its demographics, features, diagnostics, treatment and outcome with comparison to western population. Method: Choroidal melanoma constitutes most common intraocular malignancy with early appearance in Asian population. This is the 1st case series from a hill state of Uttarakhand, northern India involving medium to large size tumour with extraocular extension. In this retrospective study we assessed the prevalence, clinical presentation, diagnostic modalities, treatment plan, disease outcome, prognosis with survival and mortality. The study was carried out in time duration from February 2019- March 2021. Results: Data shows the presence of five patients, four male and 1 female in age range of 47-77 years, with median age at 62 years. Patient presented with visual equity in range of 6/18 to perception of light in time range of six months to 2 years. Fundus examination revealed presence of medium to large size choroidal mass with surface pigmentation and serous detachment. Neovascular glaucoma was present in three patients. Three patients underwent brachytherapy with I 125 and Ru 106, two cases responded well to therapy, one case presented with recurrence of tumour and neovascular glaucoma, underwent preenucleation radiation with external beam radiation therapy (EBRT) and the eye was lost following enucleation. Among five patients three underwent enucleation and thereafter were referred to surgical oncology for enlarged regional and cervical chain of lymph nodes for suspected metastasis. Histopathology via fine needle aspiration cytology (FNAC) or biopsy from whole specimen showed two cases of spindle cell, one of mixed cell variety and two of epitheloid cell type. Two cases of eitheloid cell type and one of spindle cell type needed EBRT as there was extraocular extension. All cases with enucleation were adviced an ocular implant. A diligent post treatment follow was maintained to look out for local recurrence and distant metastasis. Conclusion: Hill states have poor accessibility to healthcare. Our study shows existence of choroidal melanoma may be much larger than anticipated and cases could have been missed, hence making the need for dilated fundus examination a requirement and necessity. Histopathology, serology and imaging are much needed tools for diagnosis and staging of disease along with treatment of choroidal melanoma eventually indicating prognosis, survival and mortality. Treatment modalities as brachytherapy and EBRT are more frequently being used, indicating a shift in treatment more towards organ salvaging and preservation so as to maintain best visual function. VL - 6 IS - 4 ER -
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