**3.6 Prognosis**


### **3.7 Newer innovations**


Based on the location, they can be classified into

c. Iridotrabeculociliary or iridociliary melanoma

The most common differential diagnosis of uveal melanoma is anevus. The following are the key points to differentiate the two (pneumonic: ABCDEF):

Iris melanoma constitutes about 4% of uveal melanomas [14]. The mean age at presentation is 40–47 years. It is very rarely seen in the pediatric age group. Males and females are equally affected. It is most commonly seen in Caucasians (97.8%) [15].

Nodular pigmented lesion usually seen in the inferior iris. It is usually associated with tumor seeding in the adjacent iris or trabecular meshwork and secondary glaucoma.

2.Local resection (iridectomy/iridocyclectomy) for tumors less than 3–4 clock hours

b. Trabecular meshwork melanoma

*DOI: http://dx.doi.org/10.5772/intechopen.93760*

d. Ciliary body melanoma

f. Ciliochoroidal melanoma

e. Choroidal melanoma

1.Age ≤ 40 years

2.Blood vessels

3.Clock hours inferiorly

4.Diffuse configuration

5.Ectropion uveae

6.Feathery margin

*4.1.2 Clinical presentation*

1.Circumscribed

1.Observation of clinically suspicious lesions

**4.1 Iris melanoma**

*4.1.1 Epidemiology*

*4.1.3 Types*

**37**

2.Diffuse

*4.1.4 Management*

a. Iris melanoma

*Ocular Melanoma*

#### **Table 1.**

*AJCC 8th edition classification of conjunctival melanoma.*

1.Pembrolizumab—for recurrent conjunctival tumors [12]

2.Nivolumab [13]

#### **4. Uveal melanoma**

It is the most common primary intraocular malignancy in adults. The earlier detection and prompt treatment has decreased the morbidity to some extent over the years.

*Ocular Melanoma DOI: http://dx.doi.org/10.5772/intechopen.93760*

Based on the location, they can be classified into

a. Iris melanoma

**3.7 Newer innovations**

*Melanoma*

T1a < 1 quadrant T1b > 1 but <2 quadrants T1c > 2 but <3 quadrants

T3a Globe T3b Eyelid T3c Orbit

**Definition of primary clinical tumor (cT)** TX Primary tumor cannot be assessed T0 No evidence of primary tumor T1 Tumor of the bulbar conjunctiva

T3 Tumor of any size with local invasion

**Definition of regional lymph nodes (N)** NX Regional lymph nodes cannot be assessed N0 Regional lymph node metastasis absent N1 Regional lymph node metastasis present **Definition of distant metastasis (M)**

**Definition of primary pathological tumor (pT)**

Tis Tumor confined to conjunctival epithelium

M0 Distant metastasis absent M1 Distant metastasis present

TX Primary tumor cannot be assessed T0 No evidence or primary tumor

T1 Tumor of bulbar conjunctiva

T2 Tumor of nonbulbar conjunctiva

T3 Tumor of any size with local invasion

T2 Tumor of nonbulbar conjunctiva (forniceal, palpebral, tarsal, caruncle) T2a Noncaruncular and < 1 quadrant nonbulbar conjunctiva T2b Noncaruncular and > 1 quadrant nonbulbar conjunctiva T2c Caruncular and < 1 quadrant nonbulbar conjunctiva T2d Caruncular and > 1 quadrant nonbulbar conjunctiva

T3d Nasolacrimal duct and/or lacrimal sac and/or paranasal sinuses

T1a Tumor with <2 mm thickness invasion of substantia propria T1b Tumor with >2 mm thickness invasion of substantia propria

T2a Tumor with <2 mm thickness invasion of substantia propria T2b Tumor with >2 mm thickness invasion of substantia propria

T3d Nasolacrimal duct and/or lacrimal sac and/or paranasal sinuses

T4 Tumor of any size with invasion of central nervous system

*AJCC 8th edition classification of conjunctival melanoma.*

T4 Tumor of any size with invasion of central nervous system.

1.Pembrolizumab—for recurrent conjunctival tumors [12]

It is the most common primary intraocular malignancy in adults. The earlier detection and prompt treatment has decreased the morbidity to some extent over

2.Nivolumab [13]

T3a Globe T3b Eyelid T3c Orbit

**4. Uveal melanoma**

the years.

**36**

**Table 1.**


The most common differential diagnosis of uveal melanoma is anevus. The following are the key points to differentiate the two (pneumonic: ABCDEF):

