Transretinal choroidal tumor biopsy with a 25-gauge vitrector

To describe and evaluate transretinal biopsy of choroidal tumors using 25-gauge vitrectomy instrumentation.

Retrospective, consecutive, noncomparative case series.

Fourteen patients undergoing choroidal tumor biopsy at an ocular oncology center.

The biopsies were performed under local or general anesthesia, alone or in combination with ruthenium plaque or tantalum marker insertion. Immunohistochemistry was performed on all samples, and some melanomas were also analyzed cytogenetically.

Surgery was uneventful in all cases. A positive tissue diagnosis was made in 13 of 14 patients, albeit at the second attempt in 1 patient. The only failure occurred because the tumor was calcified.

Transretinal choroidal biopsy with 25-gauge instrumentation yields a larger sample than fine-needle aspiration biopsy, usually producing sufficient tissue for cytogenetic studies. We did not identify safety concerns in this series of patients. Insufficient samples can occur in some patients, and further studies are needed to understand the reason for such failure.