[Iris melanoma: correlation of clinical, morphometric, pathomorphological features and infectious status]

Iris melanoma is a rare malignant tumor of melanocytic origin. Oncogenic viruses, whose invasion of the cell alters proliferation regulation mechanisms, play an important role in tumor development and progression.

To identify clinical, morphometric, and pathomorphological correlations with infectious status in patients with iris melanoma and to determine predictors of unfavorable prognosis.

Sixteen patients with iris melanoma were examined. Anterior segment optical coherence tomography (AS-OCT) was performed using the RS-3000 Advance system (Nidek, Japan) with OCT-Angiography software. The specific humoral response to herpesviruses was assessed by detecting IgG and IgM antibodies in blood serum via enzyme-linked immunosorbent assay (ELISA) using an automated immunoassay analyzer LAZURITE (Dynex Technologies Inc., USA). Statistical analysis employed Spearman's rank correlation coefficient (r_s).

Iris melanoma was predominantly observed in female patients (n=11) of advanced age (n=8). Biomicroscopy revealed 10 pigmented, 1 hypopigmented, and 5 non-pigmented tumors. The mean prominence on OCT was 1461.7±740.5 μm, the basal diameter was 3409.6±1822.8 μm, and the volume was 4.7±3.7 mm³. Ciliary body involvement was detected in 10 patients. Iris melanomas were classified as epithelioid-cell (n=1), spindle-cell (n=12), and mixed-cell (n=3) types. Extrabulbar growth was noted in three patients. Serological markers of viral reactivation were identified: herpes simplex virus type 1 (n=11) and type 2 (n=5), and cytomegalovirus (n=3).

Direct correlations (r_s=0.5-0.8) were identified between the presence of serological markers of herpesvirus reactivation and unfavorable prognostic features, including advanced age, maximum tumor basal diameter, ciliary body involvement, dense pigmentation, and extrabulbar growth. The mean follow-up period was 18.5±2.97 months, and all patients were alive, with no evidence of recurrence.

The findings of this study demonstrated a correlation between herpesvirus reactivation and unfavorable prognostic features of iris melanoma. Further research is needed to deepen the understanding of the role of herpesviruses in the pathogenesis of iris melanoma and to develop personalized approaches to prevention and treatment.