[Uveal melanomas and vitreous hemorrhage. Diagnosis and treatment]

In choroidal melanoma vitreous hemorrhage can occur as initial event or as complication of conservative therapy. To understand better these relations, four groups of cases were examined: 1.) 126 choroidal melanomas which were treated conservatively with Cobalt 60 applicator from 1969 till 1984. 2.) 715 choroidal melanomas which have been treated with proton-beam from 1984 to 1989. 3.) 7 tumors or pseudotumors for which for diagnostic purposes a phosphorus 32 test was necessary. 4.) 9 choroid melanomas which had conservative treatment and where vitrectomy was realized. The multifactorial analysis gave the following results: in vitreous hemorrhages occurring before treatment the thickness of the tumor represents the significant factor. In vitreous hemorrhages which occur after conservative treatment there is in the group of cobalt applicators important irradiation of the disc, as well as the thickness of the tumor and the age of the patient in the group with proton-beam irradiation. Vitreous bleeding occurring before or after therapy does not influence the vital prognosis in a negative way. We present here a therapeutic concept in cases of vitreous bleeding in choroid melanoma which is based both on our experience and on the indications of literature.