title: Presumed small choroidal melanomas with serous macular detachments with and without surface laser photocoagulation treatment.
abstract: We reviewed the records of 22 patients (22 eyes) who had presumed small choroidal melanomas associated with a serous macular detachment. In 13 eyes, the tumor surface was treated with laser photocoagulation to reattach the retina and improve vision. After photocoagulation, the retina reattached in 11 eyes (85%), and the visual acuity improved in eight eyes (62%), returning to 20/25 or better in six eyes (46%). Twelve of the tumors (92%) that received surface photocoagulation grew after treatment. Seven of these tumors (54%) developed a collar-button configuration and showed evidence of basal expansion. Of the nine tumors that did not receive surface photocoagulation, seven (78%) eventually grew, but none developed a collar-button configuration. Surface photocoagulation applied to a growing melanoma appears to increase the likelihood of tumor extension through Bruch's membrane in a collar-button configuration. The impact of such growth on tumor metastasis is unknown.
authors.affiliation: Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905.
authors.forename: J C
authors.initials: JC
authors.lastname: Erie
authors.forename: D M
authors.initials: DM
authors.lastname: Robertson
authors.forename: W F
authors.initials: WF
authors.lastname: Mieler
mesh_terms: D000328:Adult; D000368:Aged; D002830:Choroid Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D008266:Macula Lutea; D008297:Male; D008545:Melanoma / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008875:Middle Aged; D012163:Retinal Detachment / Q000150:complications* / Q000601:surgery; D013997:Time Factors; D014792:Visual Acuity