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In Reply.–We agree with Ms Lang that there are problems in obtaining follow-up data in studies of uveal melanoma and that these problems can lead to erroneous conclusions. We would also like to stress that these problems go beyond the one stated by Ms Lang. Because uveal melanomas are frequently characterized by late manifestation of metastases, no matter how long we are able to follow up the patient, we can never exclude the possibility that the patient harbors occult microfoci of metastatic tumor. Ms Lang stressed patients "lost to follow-up," but the same problem applies to patients who die of unrelated causes. For example, a patient who died of a "heart attack" seven years after enucleation might have had metastases develop from the ocular melanoma if he had not suffered the myocardial infarction. Because of the importance of follow-up, only those cases in which the patients were alive and
McLean IW, Foster WD, Zimmerman LE. Lost to Follow-up-Reply. Arch Ophthalmol. 1977;95(6):1082. doi:10.1001/archopht.1977.04450060169026