Skip to main content
. 2024 Aug 5;12(8):1758. doi: 10.3390/biomedicines12081758

Table 4.

Overview of current therapeutic approaches for uveal melanoma.

Therapeutic Approach Method Indication Disadvantages References
Surgical resection Complete or partial removal depending on tumor size and location Localized tumors [155]
Enucleation Complete removal of the globe Thickness > 12 mm
Basal diameter >18 mm
Tumor seeding into the trabecular meshwork
Extraocular involvement
Melanoma-related glaucoma		 Poor prognosis in case of tumor recurrence [156,159,160]
Exenteration Removal of the globe and its surrounding structures, such as the muscles, fat, nerves, and eyelid Thickness > 12 mm
Basal diameter >18 mm
Multifocal or recurrent disease
Painful eye
Extraocular involvement		 Poor prognosis in case of tumor recurrence [157,158]
Radiation therapy Plaque brachytherapy: Localized application of internal radiation through plaque (containing radioctive source) suturing on episclera. Small and medium sized tumors Associated with radiation-induced complications, such as:
  • -

    Poor visual outcome

  • -

    Radiation-induced cataracts

  • -

    Vitreous hemorrhage

  • -

    Neovascular glaucoma

  • -

    Secondary glaucoma

  • -

    Retinal detachment

  • -

    Radiation retinopathy, maculopathy

  • -

    Optic neuropathy


Contraindicated in tumors < 2 mm from the optic disc and large tumors

Limited adaptability of the applicator to the area, leading to increased radiation exposure		 [161,162]
Proton beam radiotherapy: Tantalum marker (beam) placement within the tumor for direct radiation for 4 days Tumor height > 5 mm
Narrow base
Tumors close to optic nerve
Ciliary body involvement greater than one clock hour
Extraocular involvement
Iris and ciliary body melanomas		 Associated with radiation-induced complications (as mentioned above)

Limited availability		 [161,162,163,164,165,166,167]
Photocoagulation Laser used to burn and destroy tumor cells Small, peripheral tumors Increased risk of recurrence

Increased risk of extension through Buch’s membrane
Associated with increased risk for:
  • -

    Choroidal neovascularization

  • -

    Macular edema

  • -

    Retinal detachment

  • -

    Vitreous hemorrhage

 [154,168]
Transpupillary thermotherapy Near-infrared diode laser Small, accessible tumors Associated with risks of:
  • -

    Retinal vascular occlusions

  • -

    Macular edema

  • -

    Vitreous hemorrhage

  • -

    Retinal detachment

  • -

    Optic disc atrophy

 [154,169]