Uveal melanoma – is a biopsy safe and justified?

Uveal melanoma can be typically diagnosed based on clinical presentation and the A and B mode ultrasound. In some atypical intraocular tumours or for prognostic purposes intraoperative biopsy may be performed. Uveal melanoma biopsy is not safe in 100% and can cause complications (vitreous hemorrhage, retinal detachment and endophthalmitis). Like all biopsies, a biopsy in uveal melanoma biopsy may show limited cellularity and can yield insufficient tissue specimen for histology, cytology and genetic testing. This is most likely in small tumours, below 3 mm in thickness. Another limitation of biopsy-based prognosis is the issue of intratumoural heterogeneity. As a biopsy allows for only a small sample to be removed from the tumour, it is possible to receive false negative results. The most devastating complication of uveal melanoma biopsy is the extraocular spread of the tumour. The study is a review of the current opinions and findings on the role of biopsy in uveal melanoma.