PURPOSE: To review the management of ciliary body and @entity320 ( @entity2184 [ @entity2184 ]) over the last century with an emphasis on changing concepts. DESIGN: Retrospective review. @entity1 : Review of personal experience over 40 years and pertinent literature on management of @entity2184 . METHODS: Diagnosis and therapy for @entity2184 . MAIN OUTCOME MEASURES: @entity1 survival. RESULTS: In the early 1900s, most @entity1 presented with a large symptomatic @entity320 that necessitated enucleation, and the systemic prognosis was poor. In the 1970s, controversy erupted regarding the role of enucleation for @entity2184 . Some authorities advocated prompt enucleation, and others proposed that enucleation promoted @entity3 , known as the "Zimmerman hypothesis." Others recommended observation, withholding treatment until @entity5 growth was documented. During the 1970s, there was a trend toward eye-saving procedures, including laser photocoagulation, surgical @entity5 , and techniques of radiotherapy. Despite local treatment success, systemic prognosis remained guarded with approximately 40% mortality overall. However, there was convincing evidence that @entity5 offered a significantly better prognosis. Currently, there is a movement toward earlier identification and treatment of small @entity320 using clinical factors predictive of malignant potential, in keeping with similar philosophy regarding other @entity5 . Further understanding of @entity320 cytogenetics and molecular pathways have helped to recognize @entity1 at risk for @entity3 . At-risk @entity1 are offered systemic therapeutic trials to prevent @entity3 . We anticipate that the future management of @entity2184 will focus on detection of clinical and imaging clues for earliest diagnosis, prompt local @entity5 treatment, and systemic targeted therapies for microscopic @entity3 or prevention of @entity3 . Personalized evaluation of @entity1 -specific @entity320 molecular pathway signature could allow for therapeutic intervention at a site specific to the pathway abnormality that leads to the development of @entity320 . CONCLUSIONS: Management of @entity2184 has made major strides over the past century from the days of enucleation for massive, fatal @entity5 to early detection of @entity5 with a more favorable prognosis. Current and future targeted specific @entity5 pathway interruption using systemic agents could improve survival.

Management of XXXX : Past, Present, and Future: The 2014 Charles L. Schepens Lecture.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'Patient', 'PARTICIPANTS'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'smallest tumors', 'removal of tumor', 'cancers', 'smaller tumors'] @entity2184 :: ('MESH:C536494', 'Disease') :: ['PUM', 'posterior uveal melanoma'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis'] @entity320 :: ('MESH:D008545', 'Disease') :: ['melanoma', 'melanomas', 'choroidal melanoma']
@entity2184 :: (MESH:C536494,Disease) :: ['Posterior Uveal Melanoma']
