Ultrasonography of pathologically proved choroidal melanoma with a high-resolution small-parts scanner

Between March 1983 and March 1985, 13 patients with choroidal melanoma underwent ultrasonography with a high-resolution small-parts scanner. The patients subsequently underwent enucleation, and the specimens were examined histopathologically. We reviewed the ultrasonograms for the presence of choroidal excavation, rupture through Bruch's membrane, retro-orbital fat shadowing, acoustic texture and retinal detachment. Comparison with the histopathological results showed that when conventional diagnostic criteria were used, most cases of rupture through Bruch's membrane were missed owing to the limits of resolution. No patients with homogeneous acoustic texture had pathological evidence of tumour necrosis or hemorrhage, while most of those with inhomogeneous texture did. The results suggest that high-resolution small-parts scanning may lead to reassessment of the conventional criteria for the diagnosis of intraocular melanomas.