Follow up Eye Appointments
After your diagnosis your physician will discuss with you follow up procedures. Follow up care is important to manage your ocular melanoma. Keeping regular appointments with your ocular oncologist will ensure that your tumor has been successfully treated and any side effects of your treatment managed. You may experience some radiation retinopathy, double vision, floaters and flashes. If you experience any unusual symptoms, contact your physician immediately.
Surveillance Monitoring
You should be referred to an oncologist familiar with ocular melanoma for follow up scans to monitor for disease progression. Your physician will recommend the scans that would be best for you, however there are some recommendations to consider. The most common scan protocol is an MRI, with and without contrast, of the abdomen with a CT of the chest. These test should be preformed in a frequency determined by your risk of disease progression. Typically Class 1 is every 6 months and Class 2 is every 3 months for the first 2 years. Some doctors do prefer an UltraSound of the liver and a chest X-Ray in replace of the MRI or in addition to.
NCCN Guidlines for Surveillance of Uveal Melanoma
Low risk, Class 1, Disomy 3, Gain of Chromosome 6p, EIF1ax Mutation, T1(AJCC)
Imaging every 12 months
Medium risk Class 1B SF3B1 Mutation, T2 and T3 (AJCC)
Imaging every 6-12 months for 10 years then as indicated
High risk Class 2, Monosomy 3, Gain of chromosome 8Q, BAP1 mutation, PRAME expression, T4 (AJCC)
Chest Abdominal/pelvic Ct with contrast
3-6 months for the first 5 years then every 6-12 months for years 6-10, every 12 months there after.
Always discuss any medical tests with your physician and make the decision that best fits your individual situation.
MRI
MRI or Magnetic resonance imaging (MRI) of the body uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the inside of your body. It may be used to help diagnose or monitor treatment for a variety of conditions within the chest, abdomen and pelvis. Dr. Sato of Thomas Jefferson University recommends using Eovist ® contrast.
CT or CAT
Cat scans produce cross-sectional images of the body using X-rays and a computer. CT scans are also referred to as computerized axial tomography.
Ultrasound
Ultra Sound imaging of the abdomen uses sound waves to produce pictures of the structures within the upper abdomen. It is used to help diagnose pain or distention and evaluate the kidneys, liver, gallbladder, pancreas, spleen and abdominal aorta. Ultrasound is safe, noninvasive and does not use ionizing radiation.
Chest X Ray
A Chest X-Ray is a fast and painless imaging test that uses certain electromagnetic waves to create pictures of the structures in and around your chest. This test can help diagnose and monitor conditions.
Pet Scan
A positron emission tomography (PET) scan is an imaging test that allows your doctor to check for diseases in your body. Your doctor may order a PET scan to inspect your blood flow, your oxygen intake, or the metabolism of your organs and tissues. PET scans show problems at the cellular level, giving your doctor the best view of complex systemic diseases.
