Ocular oncology in the Asian subcontinent: A systematic review of epidemiology, diagnostic advances, and therapeutic trends

Ocular oncology represents a rapidly evolving subspecialty within ophthalmology, with substantial regional variations in disease spectrum, diagnostic practices, and therapeutic accessibility. This systematic review aims to synthesize epidemiologic patterns, diagnostic innovations, and treatment trends in ocular malignancies across the Asian subcontinent. A comprehensive search of PubMed, Scopus, Web of Science, and regional databases was conducted for studies published between 2000 and 2025, using PRISMA guidelines. Eligible studies included population-based cohorts, clinical trials, and institutional registries reporting on uveal melanoma, retinoblastoma, conjunctival melanoma, sebaceous gland carcinoma, and lymphoma. Data extraction and quality assessment were performed independently by two reviewers. Findings reveal a disproportionate burden of retinoblastoma and ocular surface squamous neoplasia (OSSN) in South Asia, with emerging documentation of uveal melanoma in East and West Asian populations. Diagnostic advances including optical coherence tomography (OCT), anterior segment imaging, and molecular profiling are transforming early detection. Therapeutic innovations such as plaque brachytherapy, targeted chemotherapy, and minimally invasive resection have improved survival outcomes, yet access disparities persist between urban tertiary centers and rural regions. This review underscores the need for region-specific registries, molecular epidemiology studies, and collaborative ocular oncology networks across Asia to improve early detection, equitable care, and research standardization.