In Reply We appreciate the important points raised by our colleagues in Italy, Rosa et al and Silvestri et al, regarding the association between uveal melanoma and myotonic dystrophy.1 Detecting an association between 2 rare diseases can present a challenge. We cited a prior publication from Win et al2 describing a 28-fold increased risk of uveal melanoma in patients with myotonic dystrophy, based on the detection of 2 cases in 307 patients. We then presented 6 additional cases, exemplifying this association.1 The letter from Rosa et al and a study by Bianchi et al3 describe no cases of uveal melanoma in 268 and 255 Italian patients, respectively.
Dalvin LA, Pulido JS, Shields CL. Clarification on Uveal Melanoma Associated With Myotonic Dystrophy—Reply. JAMA Ophthalmol. 2018;136(12):1427. doi:10.1001/jamaophthalmol.2018.4184
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