Treatment of Small Choroidal Melanoma

A wide range of 5-year mortality rates has been reported for patients with small choroidal melanomas, with an average rate of about 16%.[1,2] Several studies indicate that the two most important clinical factors predictive of mortality are larger tumor size at the time of treatment and documentation of tumor growth.[3]

The management of small choroidal melanomas is controversial. The likelihood of progression from the time of diagnosis to growth warranting treatment has not been well characterized. Many ophthalmologists advocate initial observation. This initial management strategy is justified on several grounds, including difficulty in establishing a correct diagnosis, lack of documented efficacy for globe-conserving treatments, and concerns for severe treatment-related morbidity. Others have advocated earlier therapeutic intervention.[4-6]