Different tests are available for Eye cancer diagnosis development, depending on signs and symptoms, age and health status, types of tumor, and earlier medical tests. Physical examination, imaging tests, and biopsies are the diagnostic approaches for eye cancer diagnosis. Most common eye cancer diagnoses include eye examination, ultrasound, fluorescein angiography, fine needle biopsy, cytogenetics, and gene expression profiling. Tests for metastasis and risk of metastasis are done to check the other body parts through blood, commonly the liver. The imaging tests such as Computed tomography (CT or CAT) scan, Magnetic resonance imaging (MRI), and Positron emission tomography (PET) scan are carried out.
Diagnosis of Eye Cancer
Many tests are performed for diagnosis of eye cancer. Also, tests are done to learn if cancer has spread to parts other than where it started.
For instance, imaging tests may be used to diagnose bone sarcoma and to find whether it has spread or not. Benign and cancerous tumors usually look different on imaging tests 1.
The different tests can be used for a person depending upon the following factors –
- Your signs and symptoms
- The age and general health status
- The type of cancer suspected
- The result of earlier medical tests
The given tests may be used for diagnosis of Eye cancer:
- Eye examination – Most cases of melanoma are found during a normal eye examination. The doctor will examine the eye using a lighted instrument called the ophthalmoscope and a slit lamp, a microscope with a light attached to it.
- Ultrasound – An ultrasound uses sound waves to create a picture of the eye.
- Fluorescein angiography – This procedure takes an image of the blood vessels in the eye. A fluorescent dye known as fluorescein is injected into the patient’s arm. The dye moves through the body and to the blood vessels in the back of the eye. The doctor then takes many quick pictures of the eye. Fluorescein angiography can be used to eliminate eye problems other than cancer 2. Indocyanine green angiography is a similar test that uses a different indocyanine green dye.
- Fine needle biopsy – This procedure removes tumor cells from the eye with a needle. This allows the doctor to look at the cells through a microscope. As doctors can correctly diagnose more than 95% of intraocular melanoma without a biopsy, this procedure is unnecessary for most people. Furthermore, patients who receive radiation treatment will not have a biopsy in the future.
- Cytogenetics and gene expression profiling – The doctor may suggest this type of test to help gather more information about the prognosis and treatment options. Cytogenetics or gene expression profiling tests are done on a tissue sample removed during either surgery or biopsy 3. Or, sometimes, on an older tissue sample that was previously removed and preserved.
Occasionally eye tumours are categorized by “class 1” or “class 2” tumours. Based on the chromosomes in the genes, this can help determine the risk of the cancer spreading.
Cytogenetics evaluates a cell’s chromosomes, including the number, shape, size, and arrangement. Gene expression profiling is a test that detects proteins, specific genes, and other factors unique to the tumour. The results of these tests may affect the treatment options. Talk with the doctor about the benefits and risks of having one of these tests and what the results mean for your care.
- Tests for metastases and risk of metastases – A tumor that begins in the eye may spread to other parts of the body through blood, commonly the liver. The doctor may see if the tumor has spread to the liver by testing the liver enzymes levels in the person’s blood or through a computed tomography (CT or CAT) scan or an ultrasound of the liver 4.
- Computed tomography (CT or CAT) scan – A CT scan is used for the diagnosis of eye cancer. It takes images of the body inside using x-rays taken from different angles. A computer combines photos into a detailed, 3-dimensional image that shows abnormalities or tumors. A CT scan is used to measure the size of the tumor and recognize enlarged lymph nodes, which may indicate the spread of cancer. Before the scan, a contrast medium dye delivers better detail to the image. This dye can be injected intravenously into the patient or given as a liquid to swallow. Before this test, patients should tell the staff if they are allergic to iodine or other contrast media.
- Magnetic resonance imaging (MRI) – Another test used for metastasis is magnetic resonance imaging (MRI). MRI uses magnetic fields to produce detailed body images. MRI can measure the tumor’s size and identify expanded lymph nodes, indicating that cancer has increased. A contrast medium dye is given before the scan to create a better picture. This dye can be given as a pill to swallow or injected into a patient’s vein.
- Positron emission tomography (PET) scan – A PET scan creates images of organs and tissues present inside the body. A small quantity of a radioactive substance is injected into the patient’s body which is taken up by cells using the most energy. The cancer cells which use energy actively take up the radioactive substance, and the scanner then spots this substance to produce images of the body from inside. The doctor can also recommend a chest x-ray to see if cancer has spread to the lung.
- 1.Lorenzano D, Miszkiel K, Rose GE. Orbital melanoma masquerading as a “Galloping haemangioma.” Orbit. Published online March 3, 2017:81-83. doi:10.1080/01676830.2017.1279657
- 2.Shields J, Sanborn G, Augsburger J, Orlock D, Donoso L. Fluorescein angiography of retinoblastoma. Retina. 1982;2(4):206-214. https://www.ncbi.nlm.nih.gov/pubmed/6101127
- 3.Diehn JJ, Diehn M, Marmor MF, Brown PO. Genome Biol. Published online 2005:R74. doi:10.1186/gb-2005-6-9-r74
- 4.Harbour JW. A Prognostic Test to Predict the Risk of Metastasis in Uveal Melanoma Based on a 15-Gene Expression Profile. Methods in Molecular Biology. Published online October 31, 2013:427-440. doi:10.1007/978-1-62703-727-3_22