Choroidal Melanoma

  • Malignant melanoma arising in choroid
  • Arises de novo or from transformation of nevi
  • Most common primary intraocular tumor in adults, but...
  • Only 0.5 per 100,000 diagnosed yearly in United States
  • Age at diagnosis is 40-75 years, peaking at age 50
  • 5-year survival ranges from 55% to 80% even with treatment
  • Refer any patient with new vision loss with urgency depending on symptoms
  • Refer non-urgently any patient with an incidentally-noted lesion in the retina or choroid
  • Presumptive diagnosis of choroidal melanoma can be made accurately with combination of ophthalmoscopy, ultrasound, optical coherence tomography, and fluorescein angiography
  • Depending on size and location of lesion, treatment will involve radiotherapy or enucleation
  • No rigorous evidence that treatment of any kind alters survival