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Purpose: To report and analyze the circumstances of uveal melanoma detection., Methods: The records of 143 consecutive patients diagnosed in the Ophthalmology Department of Gustave Roussy Institute between September 1994 and September 2001 were analyzed. The study included 66 females and 77 males, aged from 21 to 91 years (mean, 62.75 years)., Results: The first symptom was decreased visual acuity in 37% of cases. In 34.9%, there was no functional sign and a systematic fundus exam provided the diagnosis. Of the 143 patients, 18.8% presented alteration of the visual field or scotoma, 9.9% complained of phosphenes, 9% complained of metamorphopsia, and 6.5% complained of floaters. In 5.5% of cases, there was documented tumor growth. In 2%, the presence of extrascleral exteriorization was the first sign. At the time of diagnosis, anterior tumors tended to be significantly larger than posterior tumors (p<0.007). Smaller lesions were significantly associated with a systematic detection of the tumor (p<0.005). Liver metastasis occurred more frequently with ciliary body melanomas (p<0.001), which were more frequently the largest lesions., Conclusion: These results emphasize the importance of early detection of uveal melanoma. We recommended frequent fundus examination after pupil dilatation.

Since June 1991, a Cyclotron unit with a proton beam of 65 MeV has been working at the Institute Antoine Lacassagne in Nice, France. An international cooperative group has been founded to guarantee the thorough exploitation of the facility through complete cooperation. From June 17 to December 20, 1991, 47 patients with uveal melanoma were treated; 4 of them entered the study by means of the Italian team and were treated in cooperation with the Cyclotron staff. Treatment modalities and preliminary observations are described.