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The uvea is the part of the eye that is made up of the iris (the colored part of the eye surrounding the pupil), the ciliary body (which produces the fluid within the eye [aqueous humour] and controls the ciliary muscle contractions that aid in near focus), the choroid (which provides oxygen and nourishment to the retina – the inner surface of the eye), and the pars plana (at the front of the eye, where the iris and sclera [white of the eye] touch). A melanoma is clinically characterized by malignant growth of melanocytes, cells that are dark in appearance due to the inclusion of the melanin pigment.
Uveal melanomas usually arise from the front of the iris’ surface, with extension to the ciliary body and choroid. These tumors tend to be flat and diffuse, not nodular (unlike intraocular melanomas, which are raised masses). Such tumors initially have a benign (non-spreading) clinical and cellular appearance. Uveal melanomas are the most common primary intraocular neoplasm in dogs. They are usually benign and unilateral, affecting the anterior uvea most often. However, uveal melanomas are just as often capable of destroying the eye. Anterior uveal melanomas have a four percent rate of cancerous spread through the bloodstream to the lungs and visceral organs. Choroidal melanomas rarely metastasize.
Anterior Uveal Melanoma
Your veterinarian will perform a thorough physical exam on your dog, including a complete ophthalmic exam (including testing pressure within the eye and proper drainage of the eye’s aqueous humor). A complete blood profile will also be conducted, including a chemical blood profile, a complete blood count, a urinalysis and an electrolyte panel. Evidence of metastasis may may be present in the blood profile, or the blood count may show increased white blood cells, which can be indicative of the body's immune system fighting the malignant cell growth. You will need to give a thorough history of your dog's health and onset of symptoms.
X-rays and an ultrasound may also help to determine the extent of metastatic disease in the eye. During the ophthalmic exam, tonometry will be used to measure the pressure in the eyes, and gonioscopy will be used to see if the melanoma has spread to the drainage angle. Slit-lamp biomicroscopy can be used to gage the size and location of the mass. The mass should be transilluminated, a technique which uses strong light to shine through the eyeball, illuminating it throughout as an aid to diagnosis. Indirect ophthalmoscopy can also be used to investigate the eye, with or without concomitant scleral indentation.
Uveal melanomas in dogs are usually non-spreading tumors (benign), so you may opt to monitor the eye for changes every 3–6 months. Young Labrador retrievers are prone to aggressively growing uveal melanomas and will need surgery. Removal of the affected eye (enucleation) is the suggested treatment.
Indications for enucleation: the size of the mass increases rapidly, the eye cannot be salvaged, the mass spreads diffusely within the eye, visual function is significantly impaired, invasion of the tumor outside the eye, and secondary complications (e.g., glaucoma, signs of pain, bleeding).
Removing an eye is one-sided, and is done to spare the fellow eye. One-eyed animals often function very well, adjusting to the change in visual capacity quickly. If your dog develops glaucoma secondary to an uveal melanoma, your dog will very likely suffer a good deal of great pain. The resulting headaches may manifest as head shaking, head pressing, whining, placing the paws on the head, or lethargy and slow movements.
Your veterinarian will schedule follow-up appointments for X-ray and ultrasound imaging at six and twelve months following the initial surgery or treatment. At these appointments, your veterinarian will evaluate the enucleation site as well as check for tumor recurrence or metastasis.
The layer of the eye that is charged with receiving and processing images
Anything having to do with the eye or care of the eye
The growth of pathogens away from the original site of the disease
The outer layer of the eye that helps it to keep its round shape; the eye white.
The occurrence or invasion of pathogens away from the point where they originally occurred
A condition of having only one side
Anything pertaining to an organ
The term used to refer to the part of the eye containing the iris, the cilia, and the choroid.
An in-depth examination of the properties of urine; used to determine the presence or absence of illness
The term for the dark pigment in the cells of skin and hair
The condition of being drowsy, listless, or weak
A disorder that has resulted from intraocular pressure
The removal of a whole organ; usually the eye ball
Not being able to cause harm; the opposite of malignant.
Term used to refer to the liquid that gives nourishment to the structures inside the rear segment of an animal's eye.
A nonliving substance in a cell
Transmitting genes from parent to child
In veterinary terms, used to refer to the front of the body.
The colored layer around the pupil
Found inside the eye
Something that becomes worse or life threatening as it spreads