Ocular Oncology Practice During the COVID-19 Pandemic

The COVID-19 pandemic created a worldwide shift in how physician deliver optimal medical care. Ocular oncology practices have had to adapt to new challenges including how the delivery of service is performed in order to minimize SARS-CoV-2 exposure without sacrificing quality. Understanding the individual characteristics of every practice will maximize the efforts to adapt to this new reality. Telemedicine, virtual waiting rooms, and personal protective equipment have become the new standard during these unprecedented times. During clinic and operating room, our practices have had to strive for a new level of synchrony between patient and physician availability to minimize wasted time and exposure risk. Overall, medical care should not be delayed or deferred in patients with malignant ocular tumors during the COVID-19 pandemic;however, implementing safety measures for patients and healthcare workers is crucial to successfully continue to practice ocular oncology. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

COVID-related choroiditis masquerading as a choroidal melanoma

In the last two years, considerable attention has focused on eye disorders in the COVID-19 infection. The damage to the inner tunic of the eye is the most dramatic. The authors address hemodynamic abnormalities in these patients occurring during the disease and in the post-COVID-19 syndrome as demonstrated by optical coherence tomography (OCT) and OCT angiography (OCTA). Clinical presentations of COVID-related choroiditis are similar to those of other choroidites. This paper discusses a 66-year-old man with COVID-related choroiditis masquerading as choroidal melanoma who experienced the COVID-infection in April–May 2021. Clinical echographic signs of COVID-related choroiditis are described. The pathomorphology of this condition is uncovered for the first time. By comparing morphological signs in the choroid typical for cell damage with viruses and signatures of the pathological process in the inner tunic of the eye, the disease was interpreted as a COVID-associated choroiditis. The authors conclude that attention should be paid to both early vision loss and its rate when differentiating between tumor-and non-tumor-related choroid disorders. © 2022, Medicine-Inform LLC. All rights reserved.

The Trends of Uveal Melanoma Research in the Past Two Decades and Future Perspectives.

Evaluation of the research trends in uveal melanoma in the past two decades. Data were extracted from the Web of Science database website. VOSviewer and Citespace software were used to analyze the retrieved data. The leading country in terms of output and international collaboration is the USA. Research interest in genetic mutations, molecular pathways, and immunotherapy was remarkable in recent years. Most of the top ten journals are specialized in ophthalmology. In recent years, the hotspots include future perspectives, BAP1 mutation, therapeutic target, and systematic reviews. The keywords with the strongest citation bursts are immunotherapy, outcome, and in situ hybridization. The output of uveal melanoma research increased during the past two decades. Before 2015, the main focus of the research was to facilitate prognostication and metastatic risk stratification. Recently, research has moved to examine the metastatic microenvironment. Future research foci may include exploring the role of different mutations, immunotherapy, molecular alterations, and finding ideal clinical biomarkers.

Detecting Progression of Melanocytic Choroidal Tumors by Sequential Imaging: Is Ultrasonography Necessary?

Purpose: To determine if ultrasonography is necessary to detect progression of choroidal melanocytic tumors undergoing sequential multi-modal imaging with color photography, autofluorescence (AF) and optical coherence tomography (OCT). Methods: All patients with choroidal melanoma undergoing treatment at Moorfields Eye Hospital between January 2016 and March 2020 were reviewed to identify those with treatment deferred by ≥2 months. Tumors that showed progression prior to treatment, defined as an increase in (a) basal dimensions (b) thickness (c) orange pigment and/or (d) sub-retinal fluid, were included. Mushroom shape, Orange pigment, Large size, Enlargement and Sub-retinal fluid (MOLES) scores were assigned to all tumors at earliest date and date of treatment. Results: A total of 99 patients with a mean age of 66 years (range: 26-90) were included. The initial MOLES score was 1 in 2 cases, 2 in 23 cases, and ≥3 in 74 cases. Progression was detected with sequential color photography alone in 100% of MOLES 1/2 and 97% of lesions with a MOLES score of ≥3. When findings on AF and OCT were included, sensitivity for detecting subtle change without ultrasonography improved to 100% for MOLES 3 and 97% for MOLES 4/5. Only one patient included in this study had an isolated increase in thickness that may have been missed had sequential ultrasonography not been performed. Overall, the sensitivity for detecting progression with color photographs alone was 97% (95% CI 93-100%) and increased to 99% (95% CI 97-100%) by including autofluorescence and OCT. Conclusions: Monitoring of choroidal nevi, particularly those classified as MOLES 1 or 2 (i.e., low-risk or high-risk naevi), can be accomplished safely without the need for ultrasonography. The findings of this study may remove barriers to the implementation of tele-oncology clinics for the monitoring of choroidal melanocytic tumors.