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Susan Regan, PhD; Heidi E. Judge; Evangelos S. Gragoudas, MD; Kathleen M. Egan, ScD

Arch Ophthalmol. 1999;117:811-814.

Background  Ocular melanoma may be more prevalent among patients with light irises than those with dark irises.

Objective  To examine a large clinical series of patients with intraocular melanoma to determine if light irises are associated with increased risk of death from these tumors.

Methods  A total of 1162 patients treated with proton irradiation between 1984 and 1996 were observed through 1997.

Results  Iris color in the patients was blue or gray in 48%, green or hazel in 30%, and brown in 23%. Tumors in patients with blue or gray irises were less heavily pigmented (P<.001) and closer to the optic disc and macula (P<.001). Five- and 10-year metastasis-related death rates were 0.14 and 0.21, respectively, for those with blue or gray irises and 0.10 and 0.15, respectively, for those with darker irises (P=.02). In a Cox proportional hazards regression controlling for tumor characteristics, patients with blue or gray irises died of metastatic disease at a rate 1.90 times (95% confidence interval, 1.26-2.85) that of patients with brown irises. The rate of metastatic death was not significantly elevated for those with green or hazel irises (relative risk, 1.43; 95% confidence interval, 0.91-2.23).

Conclusion  Patients with blue or gray irises appear to be at increased risk of metastatic death from choroidal melanoma, independent of other risk factors.

From the Retina Service, Massachusetts Eye and Ear Infirmary, Boston. Dr Regan is now with the Clinical Epidemiology Unit, General Medicine Division, Massachusetts General Hospital, Boston.

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