gms | German Medical Science

Introduction: Uveal melanoma is a rare but aggressive ocular malignancy. Treatment options for advanced cases include eye-preserving approaches such as proton beam therapy combined with endoresection and enucleation. This study presents a monocentric analysis of patients treated with endoresection for eye preservation.

Methods: A total of 68 patients with uveal melanoma, presenting between January 2022 and December 2023, were analyzed. Tumor stages, the mean extent of tumor involvement in clock hours, exudative retinal detachment and visual outcomes were assessed. The visual acuity was evaluated at baseline and after 12 months.

Results: Among the 68 patients receiving proton beam therapy with endoresection afterwards, the average tumor thickness was 9.9 mm. The most common tumor stages were IIB (n=35), IIIA (n=18), and IIA (10). The average age was 53 years [range: 21–82]. The mean tumor involvement was 3.9±0.9 clock hours, with an initial mean visual acuity of 0.6±0.7 LogMAR. Exudative retinal detachment was present in 58 patients. 12 months post-treatment, the average visual acuity remained at 1.0±0.6 LogMAR. Two patients required secondary enucleation.

Conclusion: This study provides valuable insights into treatment options for advanced uveal melanoma. Especially for younger patients, proton beam therapy followed by endoresection may offer a vision-preserving alternative to enucleation.