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OCULAR TUMORS

Intraocular tumors are evaluated with a variety of diagnostic imaging technologies to make a diagnosis and create a personalized clinical plan. Benign lesions such as choroidal nevi, hemangiomas, and osteomas are typically monitored but may be treated to improve vision. Malignancies such as uveal melanoma, or metastasis of cancer to the eye, are treated in coordination with oncology teams. Procedures offered may include vitrectomy, biopsy, laser-based therapies, plaque brachytherapy (radiation treatment), or in rare cases enucleation (removal of the eye).

Occular Tumors
TYPES OF TUMORS
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In general, tumors are either benign (not cancerous) or malignant (cancerous). They may occur in different parts of the eye and cause varying visual effects depending on the specific location involved. Intraocular tumors may be found on a routine eye exam, or may cause vision problems prompting those affected to seek care. Frequently patients are referred to a Colorado Retina specialist to determine if suspicious ocular lesions should be observed or treated.

Benign tumors are not harmful to one's health, and may be observed when not affecting vision. Regular observation is recommended as some benign conditions may undergo “neoplastic transformation” to become malignant. Some types of benign tumors may be associated with systemic conditions and further testing may be needed. Examples of benign tumors include nevus, osteoma, hemangioma, congenital hypertrophy of the retinal pigment epithelium (CHRPE), and others.

Malignant tumors are associated with cancer and can affect the whole body. For some, the malignant tumor of the eye may be the first sign of systemic cancer. Malignant tumors may start in the eye, such as ocular melanoma. Other malignant tumors are metastases, which have spread to the eye from cancer in another part of the body, such as breast, lung, GI tract, prostate or other sources. Lymphoma may also evolve within the eye.

DIAGNOSTIC TESTING
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Most tumors will require periodic evaluations to monitor for change or evaluate response to treatment. The primary focus of the exam is to characterize the tumors in terms of size and shape and other qualities. Multiple imaging technologies are usually needed to create an accurate description of the tumor. This “multimodal” imaging can include specialized cameras, blood flow analysis, and ultrasound measurements. Due to the specialized testing needed exams may require two or three hours. Cancer patients will also require routine body imaging studies.

TREATMENT
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Treatment is designed to eradicate the tumor in the eye while preserving vision if possible. Fortunately, many treatment options are available including medications, injections, laser procedures, or even surgery. Benign tumors may be treated to improve vision. Malignant tumors are treated in coordination with other oncologists. Sometimes a biopsy is needed, requiring a trip to the operating room to obtain a tissue sample. Several types of lasers can be performed in the clinic, including, argon, photodynamic therapy (PDT), and diode transpupillary thermotherapy (TTT) to destroy tumor tissue. Radiation treatment (e.g. plaque brachytherapy) is also routinely performed by our team of ocular specialists at Colorado Retina. When it is not possible to save the eye, removal of the eye (enucleation) is offered. We often coordinate care with other physicians including eye doctors, oncologists, radiologists, and proton centers.

Side effects of radiation treatment applied to the eye may take years to develop and include cataracts, glaucoma, and radiation retinopathy, depending on the location and size of the tumor and the radiation dose used. Treatment of the side effects of radiation is possible, and for many it prolongs useful vision.

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Meet Your Specialists

Peter G. Hovland Headshot

Peter G. Hovland  |  MD, PHD

Leading our ocular oncology department is Dr. Peter Hovland, a renowned ophthalmologist, surgeon and founding partner at Colorado Retina Associates. Dr. Hovland and his team of trained specialists focus on the surgical and medical treatment of all types of intraocular tumors, from the most common to complex. Dr. Hovland has cared for thousands of patients from around the US with benign and malignant eye tumors, including ocular melanoma, choroidal or iris nevus, choroidal metastases and other vision threatening retinal conditions. Dr. Hovland is also actively involved in supporting the fight to find a cure for cure ocular melanoma, and currently acts as a grant reviewer for the Melanoma Research Foundation and the Ocular Melanoma Foundation.

Amanada Sisco Headshot

Amanda (Mason) Sisco  |  OSC/MA/CME

Amanda Sisco works in collaboration with Dr. Peter Hovland as Colorado Retina’s Supervisor of Oncology Services. Amanda has been with Colorado Retina for the past five years and works closely with our oncology patients to ensure they are well informed and cared for through the phases of testing, diagnosis, treatment and follow-up. Amanda was awarded the 2019 CURE OM Vision of Hope Award at the Melanoma Research Foundation’s 8th Annual Denver Gala for her advocacy work surrounding ocular melanoma patient support, treatment and care. Amanda is also co-chair of the Melanoma Research Foundation’s Treatment Center Collaborative Coalition.

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