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Target for treating uveal melanoma

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The presence of growth factors in eyes may enable patients with melanoma of the uvea to retain their eyes. The detection of vascular endothelial growth factor-A (VEGF-A) in the ocular fluid of affected eyes bodes well for new treatments in trial stage for blocking VEGF-A . This should prevent neovacularisation of the iris and neovascular glaucoma—complications which mean removal of the eye. Neovacularisation of the iris, in particular, seems to follow radiation treatment.

VEGF-A measured by enzyme linked immunosorbent assay had a median concentration of 0.8 ng/ml in aqueous samples (range: undetectable–10 ng/ml) and in vitreous samples (0.75 ng/ml (undetectable–21.6 ng/ml), significantly more than aqueous samples from control eyes (0.17 ng/ml, 0.05–0.96 ng/ml). The highest concentrations of VEGF-A (>1 ng/ml) were evident in seven affected eyes. Six of these had neovascularisation and five had received radiation treatment for melanoma. VEGF-A was located by immunohistochemistry in the anterior eye in 54% of tumours. The amounts found in ocular fluids bore no relation to tumour size, microvessel density, staining of the anterior segment, or retinal detachment.

VEGF-A was measured in aqueous samples (30 eyes) and vitreous samples (19) from eyes removed because of melanoma and in aqueous samples taken from 16 control eyes during cataract surgery. Immunohistochemistry was used to locate VEGF-A in thin sections from tumours excised from extracted eyes. Eight of the eyes with tumours had neovascularisation of the iris and 21 had retinal detachment.