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April 1983

Pretreatment Metastases in Patients With Ocular Melanomas-Reply

Arch Ophthalmol. 1983;101(4):666-667. doi:10.1001/archopht.1983.01040010665033

In Reply.  —We appreciate the thoughtful letter of Zimmerman and McLean in response to our report. Our investigation was prompted by earlier speculation by Zimmerman and coworkers that pretreatment metastases in patients with ocular melanomas are virtually unknown.1,2 This was at variance with our own clinical observations. In the absence of a prospective melanoma registry, submission of questionnaires to ophthalmologists seemed to us to be the most reliable method at hand to obtain a more accurate estimate of the incidence of pretreatment metastatic disease in these patients.Zimmerman and McLean believe that this method of obtaining data was biased by the selection of more advanced cases. We acknowledge that few small asymptomatic melanotic lesions of the choroid that were managed by observation alone were included in our data. The study did include 1,214 patients in whom therapeutic intervention was contemplated by the responding opthalmologists who saw them. These patients

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