—Drs Juster and Char question the validity of my correlating uveal melanoma doubling time and mitotic index because of inaccuracies involved in my making four assumptions. In regard to their first criticism of interobserver and intraobserver variability in estimating tumor size in my study, the lateral dimensions of tumor were determined almost exclusively from photographic measurements and the height was determined from stereophotographs, not from ophthalmoscopic estimations. While room for considerable error using these techniques still exists, it is not of the magnitude that they suggested. They suggest that their technique of considering tumor height alone some-how is superior to using three dimensions and the assumption of ellipsoidal growth in estimating tumor volume. While it was unfortunate that ultrasonographic techniques were not available during much of the time that the melanomas were observed at the Bascom Palmer Eye Institute in Miami, the technique employed in estimating tumor volume,
Gass JDM. Uveal Melanoma: Doubling Time and Mitotic Index-Reply. Arch Ophthalmol. 1986;104(2):174–175. doi:10.1001/archopht.1986.01050140026003
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