[Epidemiology, invasion and growth of non-iridic choroid melanomas and associated intraocular changes: histologic study of 223 eyes].

223 complete eyes enucleated because of a malignant uveal melanoma were studied histologically to evaluate patterns of growth and invasion and secondary intraocular changes. Eyes with primary iris melanomas or with a previous operation were excluded. The most important secondary changes are the retinal detachment usually responsible for the loss of visual function as well as the direct tumor invasion of the chamber angle and the rubeosis iridis, both able to cause a secondary glaucoma, which is often difficult to treat. The rubeosis iridis increased in frequency with increasing tumor prominence and was in no case combined with preretinal neovascularisations. The growth of malignant uveal melanomas may occur in three directions, i.e. outwards (through the outer envelope of the eye), inwards (towards the vitreous) or in the uveal plane. In any case intraocular borders manifesting different resistance against tumor invasion and thereby influencing prognosis of the disease have to be penetrated. Changes at the front of tumor invasion like loosening of the cellular union and transformation to a higher malignant cell type seem plausible but could not be demonstrated light-microscopically.