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Iris melanoma: Prognostication for metastasis.

Alexander Melendez-Moreno1, Yağmur Seda Yeşiltaş1, Jacquelyn Wrenn1

  • 1Department of Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Survey of Ophthalmology
|May 19, 2023
PubMed
Summary

Iris melanoma generally shows a low-risk prognostic status based on molecular testing. Even high-risk iris melanomas rarely metastasize, particularly when the ciliary body is not involved.

Keywords:
Gene expression profilingGeneticsIris melanomaPrognosisSurvival outcomesUveal melanoma

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Area of Science:

  • Ophthalmology
  • Oncology
  • Genetics

Background:

  • Uveal melanoma research often excludes iris melanoma.
  • Prognostic factors for iris melanoma are less understood compared to posterior uveal melanomas.

Purpose of the Study:

  • To determine the prognostic status and survival outcomes of iris melanoma.
  • To evaluate molecular prognostication techniques in iris melanoma cases.

Main Methods:

  • Analysis of 35 patients with biopsy-proven iris melanoma.
  • Utilized fluorescence in situ hybridization (FISH) and multiplex ligation-dependent probe amplification (MLPA).
  • Gene expression profiling (GEP) was performed on a subset of cases.

Main Results:

  • 90% of cases were GEP class 1A (low-risk); no cases were class 2 (high-risk).
  • 100% metastasis-free survival observed over a median follow-up of 49 months.
  • Literature review indicated low metastasis rates even in molecularly high-risk cases, especially without ciliary body involvement.

Conclusions:

  • Molecular prognostication indicates a predominantly low-risk profile for iris melanoma.
  • Iris melanoma with high-risk molecular features has a low metastatic potential unless the ciliary body is implicated.