Recent developments in the management of choroidal melanoma.
OBJECTIVE
To describe recent advances in the management of choroidal melanoma.


RESULTS
During the past 10 years, there has been a trend in the management of choroidal melanoma from enucleation to conservative nonenucleation treatments such as thermotherapy, plaque radiotherapy, charged-particle radiotherapy, and local resection. Recently published information regarding conservative management has revealed that plaque radiotherapy combined with thermotherapy offers 97% tumor control, similar to charged-particle radiotherapy. Additionally, patient survival after treatment of medium-size melanoma is similar when comparing plaque radiotherapy versus enucleation. Risk factors identifying small choroidal melanoma include patient symptoms, tumor thickness more than 2 mm, presence of associated subretinal fluid, presence of orange pigment on the tumor surface, and location of the tumor margin at the optic disc. These factors assist in early detection of choroidal melanoma.


CONCLUSIONS
The management of choroidal melanoma continues to improve with earlier detection of tumors and better treatment methods. Local tumor control is excellent with radiotherapeutic methods. Future studies should investigate control of subclinical metastasis.
Shields
Carol L
CL
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, 840 Walnut Street, Philadelphia, Pennsylvania, USA. carol.shields@shieldsoncology.com
Shields
Jerry A
JA
D002830:Choroid Neoplasms / Q000473:pathology / Q000628:therapy*; D015353:Eye Enucleation; D006801:Humans; D006979:Hyperthermia, Induced; D017075:Laser Coagulation; D008545:Melanoma / Q000473:pathology / Q000628:therapy*; D011878:Radiotherapy