Elsevier

Ophthalmology

Volume 112, Issue 9, September 2005, Pages 1599-1607
Ophthalmology

Original article
Intermittent and Chronic Ultraviolet Light Exposure and Uveal Melanoma: A Meta-analysis

https://doi.org/10.1016/j.ophtha.2005.04.020Get rights and content

Objective

To examine the association between ultraviolet light exposure and uveal melanoma.

Design

Meta-analysis.

Methods

A review of 133 published reports on risk factors for uveal melanoma revealed 12 studies that provided sufficient information to calculate odds ratios (ORs) and standard errors for ultraviolet light exposure factors. Data from these studies were extracted and categorized into intermittent ultraviolet exposure factors (welding, outdoor leisure, photokeratitis) and chronic ultraviolet exposure factors (occupational sunlight exposure, birth latitude, lifetime ultraviolet exposure index). Summary statistics were calculated for all risk factors reported by ā‰„4 independent studies.

Main Exposure Measures

Welding, outdoor leisure, photokeratitis, occupational sunlight exposure, birth latitude, and lifetime ultraviolet exposure index.

Results

For intermittent ultraviolet exposure, welding was found to be a significant risk factor (5 studies, 1137 cases; OR, 2.05 [95% confidence interval [CI], 1.20ā€“3.51]). Outdoor leisure was found to be nonsignificant (4 studies, 1332 cases; OR, 0.86 [95% CI, 0.71ā€“1.04]). Photokeratitis conferred susceptibility in 3 reports studying this variable, but there were too few studies to validate meta-analyses. For chronic ultraviolet exposure, meta-analysis found occupational sunlight exposure to be a borderline nonsignificant risk factor for development of uveal melanoma (4 studies, 572 cases; OR, 1.37 [95% CI, 0.96ā€“1.96]). Latitude of birth was found to be nonsignificant (5 studies, 1765 cases; OR, 1.08 [95% CI, 0.67ā€“1.74]).

Conclusion

This meta-analysis yielded inconsistent results associating ultraviolet light with development of uveal melanoma. There was evidence implicating welding as a possible risk factor for uveal melanoma.

Section snippets

Materials and Methods

The detailed methods of this study have been described.1 To summarize, 3 researchers (CPS, EW, ML) independently searched the literature using Medline (with both Ovid and PubMed), EMBASE, MD Consult, and the Web of Science using the following keywords: ultraviolet, ultraviolet, sun, sunlight, uveal melanoma, eye cancer, eye melanoma, uveal melanoma, nevus, and risk factor. The authors critically evaluated each study and included original observation studies that examined ultraviolet light risk

Results

After a search of the literature, 133 studies were identified that provided data on either host factors or ultraviolet light exposure. Of the 18 caseā€“control studies and 2 cohort studies15, 26 that satisfied all inclusion criteria, 12 studies provided data on ultraviolet light exposure and uveal melanomaāŽ (Fig 1) (Table 2, Table 3, Table 4). The remaining 8 studies assessed other variables, such as eye color or nevi.

Discussion

Several epidemiological studies have examined the relationship between ultraviolet light exposure and the risk of uveal melanoma, but these studies report varying results.āŽ Even after aggregating studies to calculate summary statistics, this meta-analysis yielded inconsistent evidence associating ultraviolet light with the development of uveal melanoma. There was evidence for welding as a risk factor, but not for outdoor leisure, occupational sunlight exposure, or birth latitude.

It is

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    Manuscript no. 2005-60.

    Dr Lajous is funded by the National Council of Science and Technology, Mexico City, Mexico.

    There are no conflicts of interest.

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