Dr. Rouzitalab and coworkers have presented a study (P:34-40) on epidemiologic assessments of enucleated eyes for malignant melanoma of choroidal in patients referred to Shiraz University of Medical Sciences hospitals (1990-2005). They have correctly emphasized on the lack or rarity of epidemiologic investigations of diseases in Iran and particularly in the field of the ocular cancers. Surely such investigations could be of great help for our diagnostic as well as therapeutic assessments and follow-up of the patients.

  I would like to draw attention to ocular melanocarcinoma in children under the age of 14 years, composing 3.7% of the cases which points out that this malignancy can be seen in all ages; however, they indicated that highly malignant cases (mixed and epithelial types) are seen mostly in the elderly.

  Two points in this article are noteworthy:

  1) The epithelial form of the tumor is more frequent in our country in comparison to other reports (ref. 11 and 17). This observation has already been reported in the article by Dr. Asadi-Amoli et al (ref. 13) from Farabi Eye Hospital , Tehran .

  2) The high frequency of highly malignant uveal melanoma in female population in Iran suggests a hormonal role in the pathogenesis and calls for further investigations.

Although the aim of the article has been an epidemiologic assessment on the enucleated eyes from 1990 to 2005, we should not disregard the role of modern therapies for ocular melanocarcinoma such as photodynamic therapy, proton beam radiation therapy and even intraocular excision via vitrectomy for smaller tumors which have proven their efficacies nowadays.

Hormoz Chams , MD