Management of small elevated pigmented choroidal lesions

Area of Science:

• Ophthalmology
• Oncology

Background:

• Diagnosing small choroidal melanomas can be challenging.
• The natural history of small choroidal melanomas is not well understood.

Purpose of the Study:

• To evaluate the safety and efficacy of close serial examinations for small choroidal melanomas.
• To understand the natural progression of these tumors.

Main Methods:

• Follow-up of 20 patients diagnosed with small choroidal melanomas over 2 to 20 years.
• Observation of tumor growth and patient outcomes.

Main Results:

• Eleven of 20 patients showed melanoma growth.
• Nine patients underwent enucleation; histopathology revealed spindle B or mixed cell type melanomas.
• No patients developed detectable metastatic disease.

Conclusions:

• Close serial examinations without immediate intervention are safe for small choroidal melanomas until growth is evident.
• Photocoagulation or radiotherapy offers no clear advantage over close monitoring in this patient group.