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Uveal melanoma is the most frequent intraocular tumor, with a high mortality rate due to metastases, especially liver metastases. Glycosylation represents an enzymatic process of addition of molecules of saccharides to other saccharides, lipids or proteins. Aberrant glycosylation is considered a key feature in malignant transformation and cancer progression. In uveal melanoma, the most common glycosylation changes are considered sialylation, fucosylation, and N- and I-glycan branching. The goal of this study is to identify sialic acid as a tumoral marker and the correlation with survival rate in uveal malign melanoma. The determination of sialic acid is used in other cancers to monitor the evolution of the disease and the survival rate. Sialic acid specificity is relatively low, because high levels of sialic acid-rich glycoproteins are encountered in inflammatory diseases [ABSTRACT FROM AUTHOR]

(1) Background: Uveal melanoma (UM) is a common malignant intraocular tumor that presents with significant genetic differences to cutaneous melanoma and has a high genetic burden in terms of prognosis. (2) Methods: A systematic literature search of several repositories on uveal melanoma diagnosis, prognosis, molecular analysis, and treatment was conducted. (3) Results: Recent genetic understanding of oncogene-initiation mutations in GNAQ, GNA11, PLCB4, and CYSLTR2 and secondary progression drivers of BAP1 inactivation and SF3B1 and EIF1AX mutations offers an appealing explanation to the high prognostic impact of adding genetic profiling to clinical UM classification. Genetic information could help better explain peculiarities in uveal melanoma, such as the low long-term survival despite effective primary tumor treatment, the overwhelming propensity to metastasize to the liver, and possibly therapeutic behaviors. (4) Conclusions: Understanding of uveal melanoma has improved step-by-step from histopathology to clinical classification to more recent genetic understanding of oncogenic initiation and progression. [ABSTRACT FROM AUTHOR]

Uveal melanoma (UM) is the most common primary intraocular malignancy in adults, originating in the uveal tract of the ocular globe. Spontaneous necrosis of choroidal melanomas is very rare, but some UMs may be predisposed to spontaneous necrosis due to rapid growth. The diagnosis of an extensively necrotic uveal melanoma can be challenging, because the associated intraocular hemorrhage makes impossible the direct tumor visualization during ophthalmoscopy. Ultrasonography is an imagistic tool based on sending and receiving sound waves (frequency above 20,000 Hz) with a probe which contains a piezoelectric transducer and works like a transmitter and receiver of sound waves in the same time. Ocular ultrasonography is the most commonly used imaging technique for determining the presence of a uveal melanoma, especially in opaque ocular media when dilated fundus examination of the eye cannot be made. In ophthalmology, we use two types of sound waves: an A-mode scan which uses frequencies of 8 MHz, and a B-mode scan for the visualization of intraocular structures which uses frequencies of 10 MHz. Ocular ultrasonography has many advantages in clinical practice, due to availability, no exposure to radiation and to low price. This article presents the difficulties associated with the diagnosis of necrotic uveal melanoma in the absence of fundus eye examination due to ocular opaque media. In this case, we should do the differential diagnosis with other pathologies that could resemble echographically uveal melanoma. In cases when ultrasonography cannot establish a clear diagnosis, we should use ancillary test. [ABSTRACT FROM AUTHOR]

(1) Background: Uveal malignant melanoma is the most common adult eye cancer and presents metabolic reprogramming that affects the tumoral microenvironment by altering the redox balance and producing oncometabolites. (2) Methods: The study prospectively evaluated patients undergoing enucleation surgery or stereotactic radiotherapy for uveal melanoma by following systemic oxidative-stress redox markers serum lipid peroxides, total albumin groups and total antioxidant levels (3) Results: Serum antioxidants and lipid peroxides were elevated from pre-treatment to longer-term follow-up. Antioxidants inversely correlated to lipid peroxides: higher in stereotactic radiosurgery patients pre/6/12/18 months post-treatment (p = 0.001–0.049) versus higher lipid peroxides in enucleation surgery patients pre/after/6 months post-treatment (p = 0.004–0.010). An increased variance in serum antioxidants was observed for enucleation surgery patients (p < 0.001), however enucleation did not increase mean serum antioxidants or albumin thiols; only lipid peroxides were increased post-enucleation (p < 0.001) and at 6-month follow-up (p = 0.029). Mean albumin thiols were increased for 18- and 24-month follow-ups (p = 0.017–0.022). Males who had enucleation surgery presented higher variance in serum determinations and overall higher lipid peroxides values pre/post-treatment and at the 18-month follow-up. (4) Conclusions: Initial oxidative stress-inducing events of surgical enucleation or stereotactic radiotherapy for uveal melanoma are followed by a longer-term inflammatory cascade gradually subsiding at later follow-ups. [ABSTRACT FROM AUTHOR]

Introduction. Cutaneous and uveal malignant melanomas (MM) show different metastasis characteristics, with no approved systemic treatment for metastatic uveal melanoma. Melanocytes are particularly susceptible to oxidative stress, defined as an imbalance between the formation of prooxidants and their removal by antioxidant systems. A better understanding of oxidative stress markers (lipid peroxides, albumin thiols, total antioxidants) differences between cutaneous and uveal melanoma could be useful in quantifying the different response to treatment. Materials and method. In a prospective study, 45 patients diagnosed with cutaneous MM (PC), as well as a cohort of 44 patients diagnosed with uveal MM (PU) were enrolled and separated into three distinct subgroups according to the received treatment: radiotherapy (14), enucleation (18), enucleation with postoperative systemic chemotherapy. All patients were followed-up for two years after diagnosis, obtaining seven determinations of biochemical parameters of oxidative stress – markers of lipid peroxidation inferement via malondialdehyde measurement, total thiol-albumin groups (Shoshinsky method), for the inferement of oxidative proteic degradation. Results. All levels were elevated compared to baseline in cutaneous and uveal melanoma patients: serum lipid peroxides PC 8.229, PU 8.377 versus baseline 4 μmol/100 ml, serum albumin thiols 511.8 PC, PU 479.9 versus baseline 450 μmol/L, serum total antioxidants 2.768 PC, 3.040 PU versus baseline 1.2 μmol/L, suggesting oxidative stress increase in the presence of a malign tumor. The levels in uveal melanoma patients varied more compared to those from cutaneous melanoma. Conclusions. The results indicate an increase of lipid peroxidation reaction, serum albumin thiols and serum total antioxidants, in correlation with tumor evolution, both in uveal and cutaneous melanoma compared to baseline values. As such, the presence of the tumor is an oxidative stress inductor, with anti-tumor treatment also having the ability to induce oxidative stress through the destruction of tumor cells. Changes between the two groups indicate different molecular signaling mechanisms of endogenous antioxidant activity. They are continuously increasing in cutaneous melanoma, however in uveal melanoma, at the end of the treatment, there is a decrease of recorded serum levels of oxidative parameters. It is thus suggested that uveal melanoma leads to the installation of a more pronounced oxidative stress compared to cutaneous melanoma, with an intensification of oxygen metabolism and a lower response capacity of the body, possibly related to the increased aggressiveness of this malign cell type. This could explain the increased resistance to immunotherapy of uveal melanoma when compared to cutaneous melanoma. Our results can be useful in monitoring the tumor evolution under treatment. [ABSTRACT FROM AUTHOR]

(1) Background: Ciliary body uveal melanoma is a rare subtype of uveal melanoma which comprises 3–5% of melanomas, an immunogenic cancer, and can present multifaceted initial clinical manifestations, masquerading as various ocular pathologies. Chronic lymphocytic leukemia (CLL) presents immunodeficiency and risk for the development of a secondary malignancy, with Bruton's tyrosine kinase inhibitor treatment having a mutagenic effect and a secondary anti-platelet aggregation effect. We present the case of a 65-year-old patient undergoing treatment for CLL with ibrutinib who presented with recurrent hyphema that masked an underlying, inferiorly situated, ciliary body uveal melanoma; (2) Methods: Retrospective case review; (3) Results: An ophthalmological examination together with imaging via mode B ultrasound and contrast-enhanced magnetic resonance imaging resulted in the clinical and imagistic diagnosis of a ciliary body uveal melanoma. A pathological examination of the enucleated eye confirmed the diagnosis. Postoperative tumoral reoccurrence was not detected for 1½ years, however, CLL immunosuppression worsened with admission for severe COVID-19 disease. (4) Conclusions: CLL patient screening for melanoma should also include detailed ophthalmological examinations, which could also include ultrasound ophthalmological imaging. The avoidance of uveal melanoma metastatic disease is paramount for patient survival. CLL manifests additional profound immunosuppression. [ABSTRACT FROM AUTHOR]

Malignant melanoma, although relatively uncommon compared to other skin cancers, is responsible for most fatalities from skin cancer. Although this disease does not necessarily impress by incidence, it makes special medical problems for both affected patients and clinicians who have to deal with a disease with an often dramatic evolution for which until now they didn’t have sufficient effective therapeutic resources. Uveal melanoma is the most common adult eye cancer, with an incidence 10-20 times lower than that of cutaneous melanoma and with a peak incidence around the age of 50-60 years old. The causes of its onset are incompletely elucidated so far. This article aims at presenting in a succession dictated by the steps that the medical team (ophthalmologist, oncologist, pathologist etc.) goes through from diagnosis to the most innovative treatment, along with the latest data related to uveal melanoma. Thus, the incidence data, the risk factors, the screening and the clinical aspects associated with the malignant transformations in this location are presented. The article also presents the latest protocols on clinical and paraclinical investigations, as well as recent data from the literature on the latest and most effective therapies. [ABSTRACT FROM AUTHOR]

Purpose: Our retrospective study on 27 patients with a large mean macular hole diameter (MH-D) of 480.08±78.62 μm evaluates the usefulness of combining the current internal limiting membrane (ILM) inverted-flap surgical technique with silicone oil tamponade, which has been associated with the classical technique of ILM peeling., Results: Functional results: mean visual acuity (VA) improved to 0.89±0.11 logMar (logarithm of the minimum angle of resolution, at one month), 0.67±0.03 logMar (at three months), 0.52±0.04 logMar (at six months), 0.42±0.15 logMar (at one year) postoperative (final VA), with statistical linkage between preoperative VA and final VA (two-sample t-test, p=0.007), mean MH-D and final VA (regression analysis, p=0.003). We compared the results by MH size (Group A ≤400 μm - eight eyes and Group B >400 μm - 19 eyes), finding statistical variance (Bonett & Levene methods). Group A presented a final VA of 0.21±0.12 logMar, while Group B had 0.51±0.17 logMar. Successful closure was noted in 25 (92.59%) cases, with Group A having complete closure and external limiting membrane (ELM) restoration with ellipsoid zone (EZ) regeneration in six cases. Group B had successful closure in 17 (89.47%) cases with ELM restoration in 16 cases and EZ regeneration in seven (38.88%) cases, with reintervention in two cases. Restoration of the ELM was correlated [Pearson's correlation coefficient (PCC) of 0.999, p=0.022] with successful closure, with overall restoration obtained in 24 (88.88%) cases and EZ regeneration in 13 (48.14%) cases., Conclusions: ILM inverted-flap technique with silicone oil tamponade had favorable functional and anatomical outcomes. ELM restoration was associated with successful MH closure.