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Nevoid iris melanoma, case report
Melanoma nevoide de iris, a propósito de un caso
J. David Saldaña-Garrido
, María C. Martínez-Hergueta, M. Magdalena Martínez-Rubio
Corresponding author
Servicio de Oftalmología, Hospital General Universitario de Alicante, Alicante, Spain
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David Saldaña-Garrido, María C. Martínez-Hergueta, M. Magdalena Martínez-Rubio" "autores" => array:3 [ 0 => array:4 [ "nombre" => "J. David" "apellidos" => "Saldaña-Garrido" "email" => array:1 [ 0 => "jdsalga@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "María C." "apellidos" => "Martínez-Hergueta" ] 2 => array:2 [ "nombre" => "M. Magdalena" "apellidos" => "Martínez-Rubio" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Oftalmología, Hospital General Universitario de Alicante, Alicante, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Melanoma nevoide de iris, a propósito de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 622 "Ancho" => 899 "Tamanyo" => 77463 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Temporal inferior pigmented nodule, with uneven color and surface, corectopia and hyphema.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Iris melanoma is the most infrequent uveal melanoma (3–10%), accounting for 10–24% of iris tumors.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> It is caused by the growth of pre-existing nevus and malign proliferation of stromal melanocytes that substitute the architecture of the iris.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Iris melanoma is more frequent in males between 45 and 60 years of age. Prognosis is variable, exhibiting slow growth and metastasis in 5% of cases within 10 years.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,2</span></a> Said melanoma is generally asymptomatic and is diagnosed by the presence of a nodular or diffuse mass in the iris, associated to spontaneous glaucoma and hyphema.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> The case of a patient with a pigmented nodule in the iris is presented, including documented photographic growth which, after surgical extirpation, was diagnosed as iris melanoma.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Clinic case report</span><p id="par0015" class="elsevierStylePara elsevierViewall">Male, 48, who visited the emergency section due to diminished visual acuity (VA) in the left eye (LE). Personal antecedents included photographic follow-up beginning 8 years ago due to a pigmented lesion in the inferior temporal iris of the LE, without involving pupil edge or angle. The patient did not return for checkups (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The ophthalmological exploration produced VA in the RE of 1 and 0.6 in the LE. Left eye biomicroscopy showed ¼ hyphema and inferior temporal nodule of 3<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>mm with uneven color and surface, making contact with the cornea, perilesional vasodilatation and slight inferior corectopia. IOP: 24<span class="elsevierStyleHsp" style=""></span>mmHg (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Indirect ophthalmoscopy with scleral depression discarded the presence of choroidal tumors, while ocular echography did not reveal signs suggesting intraocular masses. Gonioscopy and optical coherence tomography of the anterior pole showed that the angle was respected (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>). A systemic extension study was carried out with negative results.</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Due to a significant suspicion of iris melanoma, sector iridectomy was performed (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>), with careful dissection with viscoelastic due to corneal contact, including histopathological study (<a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>), that produced the diagnostic of low malignity nevoid melanoma in stage T1a, with free edges.</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="fig0030"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">The majority of iris tumors are benign. Melanoma is the most frequent malign tumor of the iris. Risk factors are: Caucasian race, light skin and iris and previous presence of nevus. Other factors include uvea melanocytoma and congenital ocular melanocytosis.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">It is advisable to carry out a regular follow-up of iris nevus every 3–12 months, with photographic control to document growth.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The main differences between a melanoma and the nevus are that the nevus expresses at earlier ages (puberty), size under 3<span class="elsevierStyleHsp" style=""></span>mm, flat or very slight elevation (under 1<span class="elsevierStyleHsp" style=""></span>mm depth) and not vascularized.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Data for suspecting melanoma are: age over 40, pigmented and vascularized nodule over 3<span class="elsevierStyleHsp" style=""></span>mm diameter and 1<span class="elsevierStyleHsp" style=""></span>mm depth, located in the lower half of the iris (86%),<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> uveal ectropion, hyphema or secondary glaucoma. The risk of a nevus becoming melanoma is low (4% in 10 years and 11% in 20 years).<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">There is a rule to assist in predicting the risk of malign transformation of a nevus into a melanoma, i.e. the ABCDEF rule: A (age young), B (blood/hyphema), C (clock hour inferior), D (diffuse configuration), E (ectropion in uvea) and F (feathery margins).<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The treatment of choice is sector iridectomy with subsequent reconstruction of the iris. This has the advantage of providing the complete mass for histological diagnostic, preserving the ocular globe.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> In this case, sector iridectomy was performed without initial pupil reconstruction, which was postponed for a second intervention. At presence, the patient does not refer photophobia or diplopia.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Brachytherapy with iodine 125 or palladium 103 is indicated for diffuse and unresectable tumors with a diameter over 5<span class="elsevierStyleHsp" style=""></span>mm as it provides survival rates similar to enucleation.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> The latter is performed in cases of untreatable secondary glaucoma as well as in the presence of local dissemination.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Prognosis is generally good. Mortality ranges between 0 and 11% depending on the presence of metastasis, ciliary body involvement and cell type. The best prognosis is associated to fusiform cell melanoma.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> The American Joint Committee on Cancer (AJCC) classifies iris tumors as: T1, limited to the iris; T2, when extending to the ciliary body and the choroids; T3, with scleral extension, and T4 with extrascleral extension.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> T1 tumors, as in the present case, are most frequent (56%) and have a survival rate of 100%.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">The malign transformation of a nevus into melanoma is of 4% at 10 years. In the initial stages, melanoma can present the same characteristics of the nevus, and can be differentiated only due to its faster growth.</p><p id="par0075" class="elsevierStylePara elsevierViewall">The initial image (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) induced the suspicion that it was not a typical nevus, but the lack of follow-up excluded treatment in the initial stage and the ensuing diagnostic delay.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interests</span><p id="par0080" class="elsevierStylePara elsevierViewall">No conflict of interests was declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres856942" "titulo" => "Abstract" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Case report" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Discussion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec850987" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres856941" "titulo" => "Resumen" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0015" "titulo" => "Caso clínico" ] 1 => array:2 [ "identificador" => "abst0020" "titulo" => "Discusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec850986" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinic case report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interests" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-12-17" "fechaAceptado" => "2016-04-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec850987" "palabras" => array:5 [ 0 => "Iris nevus" 1 => "Iris melanoma" 2 => "Nevoid melanoma" 3 => "Hyphema" 4 => "Uveal melanoma" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec850986" "palabras" => array:5 [ 0 => "Nevus de iris" 1 => "Melanoma de iris" 2 => "Melanoma nevoide" 3 => "Hifema" 4 => "Melanoma de úvea" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Case report</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The case is presented of a patient with diagnosis of iris nevus in the left eye in youth with a poor follow-up, who referred a decreased visual acuity in that eye. A hyphaema and a 3<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>mm nodule with irregular pigmentation was observed. Excision of the tumor and histological analysis confirmed the suspicion of iris melanoma in stage Ia.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Discussion</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Despite the low grade malignancy of iris melanoma and the low frequency of transformation of iris nevus into melanoma, a follow-up is required for its early diagnosis and treatment.</p></span>" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Case report" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Discussion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Caso clínico</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se presenta el caso de un paciente con nevus de iris en el ojo izquierdo, diagnosticado en la juventud y con mal seguimiento, que refiere disminución de la agudeza visual en dicho ojo. A la exploración se objetivó hifema y un nódulo de 3<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>mm, con pigmentación irregular. Se realizó exéresis de tumoración y análisis anatomopatológico que confirmó la sospecha de melanoma de iris en estadio Ia.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A pesar del bajo grado de malignidad del melanoma de iris, y de la escasa frecuencia de transformación de nevus de iris en melanoma, es preciso realizar seguimientos para su diagnóstico y tratamiento precoz.</p></span>" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0015" "titulo" => "Caso clínico" ] 1 => array:2 [ "identificador" => "abst0020" "titulo" => "Discusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Saldaña-Garrido JD, Martínez-Hergueta MC, Martínez-Rubio MM. Melanoma nevoide de iris, a propósito de un caso. Arch Soc Esp Oftalmol. 2017;92:347–350.</p>" ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 675 "Ancho" => 900 "Tamanyo" => 82081 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Temporal inferior iris nevus, without pupil involvement.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 622 "Ancho" => 899 "Tamanyo" => 77463 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Temporal inferior pigmented nodule, with uneven color and surface, corectopia and hyphema.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 626 "Ancho" => 899 "Tamanyo" => 58394 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Perilesional vascular dilatation.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 600 "Ancho" => 899 "Tamanyo" => 75020 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Anterior pole optical coherence tomography, with respected angle.</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 676 "Ancho" => 900 "Tamanyo" => 127567 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Sector iridectomy.</p>" ] ] 5 => array:7 [ "identificador" => "fig0030" "etiqueta" => "Fig. 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 1449 "Ancho" => 975 "Tamanyo" => 434923 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Histological section: increased vascularization and presence of nevoid, fusiform and epithelioid cells (large pleomorphic cells with large nucleus, presence of nucleole and atypia).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary iris melanoma: diagnostic features and outcome of conservative surgical treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.M. Conway" 1 => "W.C. Chua" 2 => "C. Qureshi" 3 => "F.A. Billson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br. J. Ophthalmol." "fecha" => "2001" "volumen" => "85" "paginaInicial" => "848" "paginaFinal" => "854" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11423461" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Iris nevus growth into melanoma: analysis of 1611 consecutive eyes: the ABCDEF guide" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.L. Shields" 1 => "S. Kaliki" 2 => "A. Hutchinson" 3 => "S. Nickerson" 4 => "J. Patel" 5 => "S. Kancherla" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ophtha.2012.09.042" "Revista" => array:6 [ "tituloSerie" => "Ophthalmology" "fecha" => "2013" "volumen" => "120" "paginaInicial" => "766" "paginaFinal" => "772" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23290981" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical characteristics of uveal melanoma in patients with germline BAP1 mutations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.P. Gupta" 1 => "A.M. Lane" 2 => "M.M. DeAngelis" 3 => "K. Mayne" 4 => "M. Crabtree" 5 => "E.S. Gragoudas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamaophthalmol.2015.1119" "Revista" => array:6 [ "tituloSerie" => "JAMA Ophthalmol" "fecha" => "2015" "volumen" => "133" "paginaInicial" => "881" "paginaFinal" => "887" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25974357" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Positive interaction between light iris color and ultraviolet radiation in relation to the risk of uveal melanoma: a case–control study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Schmidt-Pokrzywniak" 1 => "K.H. Jöckel" 2 => "N. Bornfeld" 3 => "W. Sauerwein" 4 => "A. Stang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ophtha.2008.09.040" "Revista" => array:6 [ "tituloSerie" => "Ophthalmology" "fecha" => "2009" "volumen" => "116" "paginaInicial" => "340" "paginaFinal" => "348" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19091418" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[Chapter 14]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Essentials of ophthalmology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N.J. Friedman" 1 => "P.K. Kaiser" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:5 [ "fecha" => "2007" "paginaInicial" => "214" "paginaFinal" => "217" "editorial" => "Saunders Elsevier" "editorialLocalizacion" => "Edinburgh" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relative survival rates after alternative therapies for uveal melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Seddon" 1 => "E.S. Gragoudas" 2 => "K.M. Egan" 3 => "R.J. Glynn" 4 => "S. Howard" 5 => "R.G. Fante" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ophthalmology" "fecha" => "1990" "volumen" => "97" "paginaInicial" => "769" "paginaFinal" => "777" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2374681" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Iris melanoma management with iodine-125 plaque radiotherapy in 144 patients: impact of melanoma-related glaucoma on outcomes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.L. Shields" 1 => "S.U. Shah" 2 => "C.G. Bianciotto" 3 => "J. Emrich" 4 => "L. Komarnicky" 5 => "J.A. Shields" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ophtha.2012.06.053" "Revista" => array:6 [ "tituloSerie" => "Ophthalmology" "fecha" => "2013" "volumen" => "120" "paginaInicial" => "55" "paginaFinal" => "61" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22980742" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Iris ring melanoma: fine needle biopsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.H. Char" 1 => "A.E. Kemlitz" 2 => "T. Miller" 3 => "J.B. Crawford" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bjo.2005.088294" "Revista" => array:6 [ "tituloSerie" => "Br. J. Ophthalmol." "fecha" => "2006" "volumen" => "90" "paginaInicial" => "420" "paginaFinal" => "422" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16547317" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Malignant melanoma of the uvea" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.B. Edge" 1 => "D.R. Byrd" 2 => "C.C. Compton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:6 [ "edicion" => "7th ed." "titulo" => "American Joint Committee on Cancer Staging Manual" "fecha" => "2010" "paginaInicial" => "541" "editorial" => "Springer" "editorialLocalizacion" => "New York" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Year Book of Ophthalmology 2013" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C.J. Rapuano" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "fecha" => "2013" "paginaInicial" => "185" "paginaFinal" => "186" "editorial" => "Elsevier Science Health Science Division" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009200000007/v1_201706250033/S2173579416301050/v1_201706250033/en/main.assets" "Apartado" => array:4 [ "identificador" => "8724" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Short communication" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009200000007/v1_201706250033/S2173579416301050/v1_201706250033/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579416301050?idApp=UINPBA00004N" ]
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