Transscleral fine-needle aspiration biopsy of macular choroidal melanoma.
OBJECTIVE
To report transscleral 30-gauge fine-needle aspiration biopsy (FNAB) for cytology and cytogenetics in eyes with macular choroidal melanoma.


METHODS
Prospective, interventional case series.


METHODS
Twenty-five patients (25 eyes) who underwent transscleral 30-gauge FNAB of macular choroidal melanoma immediately prior to iodine-125 plaque placement were included in this study, conducted at a tertiary care university hospital. The main outcome measures were FNAB feasibility, cytology, cytogenetic analysis for monosomy 3, and surgical complications.


RESULTS
Transscleral 30-gauge FNAB of choroidal melanoma in the macula was performed in 24 of 25 (96%) eyes and was not feasible owing to insufficient exposure in one eye (4%). Biopsy was diagnostic of choroidal melanoma in 17 of 24 (71%) eyes. Fluorescent in situ hybridization (FISH) and/or GeneChip 500k NspI Mapping array (Affymetrix, Santa Clara, California, USA) analysis for monosomy 3 was completed in 16 of 24 (67%) revealing monosomy 3 in five eyes and disomy 3 in 11 eyes. Retinal perforation (four eyes) did not require treatment or result in retinal detachment; submacular hemorrhage (nine eyes) and vitreous hemorrhage (five eyes) cleared spontaneously within one month.


CONCLUSIONS
Transscleral FNAB of macular choroidal melanoma is feasible in most eyes and frequently yields cytogenetic information relevant to prognosis.
Young
Tara A
TA
Department of Ophthalmology, Jules Stein Eye Institute, 100 Stein Plaza, Los Angeles, CA 90095, USA. young@jsei.ucla.edu
Burgess
Barry L
BL
Rao
Nagesh P
NP
Glasgow
Ben J
BJ
Straatsma
Bradley R
BR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D001918:Brachytherapy; D002830:Choroid Neoplasms / Q000235:genetics / Q000473:pathology* / Q000532:radiotherapy; D002893:Chromosomes, Human, Pair 3 / Q000235:genetics; D004322:Drainage; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008545:Melanoma / Q000235:genetics / Q000473:pathology* / Q000532:radiotherapy; D008875:Middle Aged; D009006:Monosomy / Q000235:genetics; D020411:Oligonucleotide Array Sequence Analysis; D011446:Prospective Studies; D012590:Sclera
D007457:Iodine Radioisotopes