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Retinal Physician

Article | 2025 Retina World Congress

A Shift in Strategy for Ocular Melanoma

Timothy Murray, MD, shares 5-year data from a large series of small choroidal melanomas that indicates early treatment improves survival and preserves vision.

By: Timothy G. Murray, MD, MBA, FACS
Retinal Physician May 11, 2025

Clinical Report: A Shift in Strategy for Ocular Melanoma

Overview

A recent study presented at the Retina World Congress 2025 indicates that early treatment of small choroidal melanomas significantly improves survival rates and preserves vision. The incorporation of genetic testing has also proven crucial in the diagnostic evaluation and management of these tumors.

Background

Ocular melanoma, particularly small choroidal melanoma, poses significant risks of metastasis and vision loss. Traditional management strategies often involved observation until tumor growth, which may have contributed to higher mortality rates. Recent findings emphasize the importance of early intervention and genetic profiling to improve patient outcomes.

Data Highlights

Class5-Year Incidence of Metastasis
1A1%
1B20%
270%

Key Findings

  • Early treatment of small choroidal melanomas leads to improved survival and vision preservation.
  • Genetic testing via gene expression profiling (GEP) is critical for accurate diagnosis and risk stratification.
  • In the study, 80% of patients were classified as class 1A, with a 5-year metastatic incidence of only 1%.
  • Significant reductions in mortality were observed, particularly in class 2 patients, where the incidence dropped from 72% to 4%.
  • Vision improved from an average of 20/70 to 20/30 in treated patients.
  • 93% of patients presented with focal retinal detachment, highlighting the need for timely intervention.

Clinical Implications

Healthcare professionals should consider early intervention strategies for small choroidal melanomas to enhance survival rates and visual outcomes. The integration of genetic testing into clinical practice is essential for effective diagnosis and management.

Conclusion

The findings from this study advocate for a paradigm shift from delayed observation to proactive treatment of small ocular melanomas, underscoring the importance of early intervention in improving patient prognosis.

References

  1. Timothy Murray, MD, Retina World Congress, 2025 -- A Shift in Strategy for Ocular Melanoma
  2. Prithvi Mruthyunjaya, MD, Retinal Physician, 2025 -- Innovation in Ocular Oncology
  3. Bria L. George, PharmD, Retinal Physician, 2023 -- New Treatments for Ocular Melanoma
  4. Jim Gallagher, Retinal Physician, 2025 -- Reducing the Risk of Radiation Retinopathy
  5. Uveal melanoma: ESMO–EURACAN Clinical Practice Guideline for diagnosis, treatment and follow-up, ScienceDirect, 2026
  6. The ASCO Post — ASCO Guideline Update for Systemic Melanoma Therapy Addresses New Treatment Option for Uveal Melanoma
  7. Long-term visual outcomes and side effects of ruthenium plaque brachytherapy in 310 eyes with small choroidal melanoma
  8. Evaluating the efficacy and safety of tebentafusp in the treatment of metastatic uveal melanoma: a 2025 update systematic review and meta-analysis
  9. Uveal melanoma: ESMO–EURACAN Clinical Practice Guideline for diagnosis, treatment and follow-up - ScienceDirect