Current Methods for the Diagnosis and Treatment of Choroidal Melanoma

Choroidal melanoma is the most common primary intraocular malignancy. Diagnosis is performed by clinical evaluation: eye cancer specialists currently use multiple diagnostic techniques, including ophthalmoscopy, fundus autofluorescence imaging (FAF), fluorescein angiography (FA), and indocyanine green angiography (ICG), as well as optical coherence tomography (OCT). Tumor biopsy has recently become popular due to the availability of diagnostic cytogenetic features, touted as biomarkers for metastasis. Standard treatments include observation (select small melanomas and indeterminate tumors), radiation therapy (plaque, proton beam), eye wall resection, and removal of the eye. Of these, ophthalmic plaque radiation therapy has become the most common and widely available conservative treatment. Successful initial treatment offers the best chance to prevent subsequent metastasis. Metastatic choroidal melanoma is typically diagnosed by combinations of physical examination, hematologic surveys, abdominal radiographic imaging (ultrasound, magnetic resonance imaging, computed tomography), and positron emission tomography–computed tomography (PET/CT). Most often initially found in the liver, metastatic choroidal melanoma carries an unfavorable prognosis for life. Herein, we report on currently available methods of diagnosis and treatment for choroidal melanoma.