Lara Cheslow, Signe Caksa, Rachel E Cain, Scott A. Waldman, Andrew E. Aplin
Recent studies have introduced aqueous humor sampling as a promising, minimally invasive alternative to diagnose ocular malignancy, guide therapeutic management, monitor response to treatment, and track early recurrence.
Ocular malignancies, though relatively rare, pose significant risks to patients' vision, quality of life, and potential for developing metastatic disease. Due to the eye's complicated and delicate anatomy, diagnosing ocular malignancy and monitoring its progression can be technically challenging. Current approaches include direct tumor biopsy, vitreous humor sampling, and imaging. However, these techniques are associated with rare, yet potentially severe, side effects and can be invasive or limited in detecting microscopic disease. Recent studies have introduced aqueous humor sampling as a promising, minimally invasive alternative to diagnose ocular malignancy, guide therapeutic management, monitor response to treatment, and track early recurrence. As oncologic biomarker research continues to progress, incorporating aqueous humor sampling into clinical practice may refine diagnosis, risk stratification, and therapeutic approaches to enhance patient outcomes. This article reviews the latest advances in aqueous humor biomarkers in common ocular malignancies, including uveal melanoma, intraocular lymphoma, and retinoblastoma.