Stereotactic radiosurgery (SRS) and fractionated stereotactic radiiotherapy (fSRT) have emerged as promising, non invasive treatments for uveal melanoma. Although, historically melanoma has been considered a relatively radioresistant tumor, newer data have challenged this viewpoint, and radiation therapy is now considered to be a useful component of the therapeutic armamentarium for malignant melanoma. But still there is a need for multicenter trials to compare the outcomes following stereotactic radiosurgery (SRS) in the treatment of uveal melanoma.
2. A 63 year old male.
Decreasing vision since 3 months in Left Eye.
f/b Complete loss of vision in Left Eye
Severe Pain in Left Eye since 5 days
Red discoloration of Conjunctiva in Left Eye
since 5 days.
3. Right Eye Vision Normal
No c/o Vertigo or vomiting
Quit Gutkha chewing and smoking 6 years
back.
Co morbidities:- Hypertensive (on treatment
since 2 years)
4. ON EXAMINATION LEFT EYE:
Prominent Conjuctival Vessels
Haemorrhage Present
Lens Opacified
Pupil Not reacting
Lids OK
Right Eye; Lens matured, Conjuctiva (N), Pupil
Reacting, Lids (N)
No Neck Lymphadenopathy
5. CT Scan (Dec2016) : e/o an enhancing
lobulated intraocular mass lesion seen
Posteriorly on left side eye.
◦ Polypoidal contrast enhanced lesion (13 x 10 x 12
mm)
◦ Choroidal Haemorrhage present- Max wall
thickness 6 mm.
◦ Abutting optic disc Posteriorly
◦ Optic Nerve -Normal
◦ No e/o Intra & Extra Coanal infiltration.
◦ Right Eye - Normal
6. Screening MRI: Shows the lesionto be
hyperintense on T1w and Hypointense on T2
w.
Chest X ray PA view 5/12/16 Normal Study
EYE Scan:- A Bilobed mass noted in the nasal
quadrant abutting optic nerve reaching up till
posterior pole with medium surface reflection
and medium internal reflection associated
choroidal excavation. Total Retinal
Detachment +nt.
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27. USG LEFT EYE (08/05/17):- A well defined
round lesion of size approx 9.7 x 9.7 mm
along the posterior wall of the orbit with
almost no internal vascularity (size is almost
same as compared to previous study).
The retinal detachment is also seen (however appears
decreased compared to previous scan).
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30. USG LEFT EYE (23/11/17):- A well defined
round lesion of size approx 9.3 x 6.6 mm
along the posterior wall of the orbit with
almost no internal vascularity (size decreased
compared to previous study).
The retinal detachment is also seen (however appears
decreased compared to previous scan).
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32. USG Left Eye (30/10/18):- A well defined
round lesion of size approximately 5.6 x 4.6
mm along the posterior wall of the orbit with
almost no internal vascularity .
Also there is adjacent presence of retinal
detachment.
Anterior chamber appears collapsed.
AP diameter of eye is decreased (16.2 mm)