• Ocular Pathology/Oncology

    Review of: Small Choroidal Melanoma: Outcomes Following Surveillance vs Immediate Treatment

    Singh A, Raval V, Wrenn J, et al., American Journal of Ophthalmology, in press

    A diagnostic predictive model for small choroidal melanoma was used to determine survival, potential for vision loss, and freedom from metastasis in patients who received immediate treatment vs those who were treated after a period of documented growth.

    Study design

    In this single-center retrospective study a predictive model was applied to patients who had undergone immediate treatment of small uveal melanoma to define high-risk vs low-risk melanoma. This model was then applied to patients who had undergone treatment for small uveal melanoma after a period of observation leading to documented growth. Vision and survival outcomes were compared between the groups.

    Outcomes

    There was no significant difference in metastasis-free survival between patients with low-risk tumors who were immediately treated vs those observed for growth before treatment. There were also no significant differences in vision outcomes between patients immediately treated vs those treated only after documented growth.

    Limitations

    The lack of pathologic confirmation of melanoma cases is a limitation in this study. Similar to many other studies for this cancer, cytopathologic diagnosis is less common than clinical diagnosis for small uveal melanoma.

    Clinical significance

    The authors suggest that based upon these data, low-risk choroidal melanoma identified by this prediction model can be considered indeterminate tumors and managed initially by surveillance without increased risk of metastatic death.