Incidence:- Choroidal melanoma is a primary malignant intraocular tumor and is one of the common types of primary malignant melanoma.
Choroid Melanoma Diagnosis:-
Ophthalmologic examination may disclose the following:
Small choroidal melanomas appear as a nodular and dome-shaped mass under the retinal pigment epithelium.
Choroidal melanomas may have uneven coloration.
Choroidal melanoma can be left undetected beneath a huge exudative retinal detachment, a sub retinal hemorrhage, or a vitreous hemorrhage.
Anterior choroidal melanomas can display sentinel vessels that feed the metabolically active tumor.
Transscleral development of an anterior choroidal melanoma may be seen during examination as an abnormal hyper pigmentation.
- 1. Ultrasonography of the eye is helpful for locating tumors that are thicker than 2-3 mm.
- 2. Choroidal melanoma typically shows an early spike, followed by internal reflectivity with retreating amplitude and a noteworthy echo.
- 3. Vascular pulsations are visible as normal oscillations of the internal spiking pattern inside the tumor.
- 4. B-scan ultrasonography of the eye is done to evaluate any posterior segment mass, especially for patients with media opacity.
- 5. B-scan ultrasonography is used to look for possible extra ocular extension for finding out the tumor size.
- 1. Fluorescein angiography and indocyanine green angiography are unable to display pathognomonic signs of choroidal melanoma . However, they are useful for initial diagnosis.
- 2. Small choroidal melanomas usually show fluorescein angiographic changes just like some choroidal nevi
- 3. Larger melanomas can illustrate a patchy outline of early hypo fluorescence and hyper fluorescence. This is usually followed by intense staining.
- 4. Concurrent fluorescence of retinal and choroidal circulation inside the tumor is reasonably distinctive of choroidal melanomas.
Signs and Symptoms of Choroid Melanoma:-
- 1. Blurred visual acuity.
- 2. Para central scotoma.
- 3. Painless and progressive visual field loss.
- 4. Floaters.
- 5. Severe ocular pain.
- 6. Weight loss, marked fatigue, cough, or change in bowel or bladder habits (suggests primary nonocular malignancy with choroidal metastasis).
Choroid Melanoma Treatment:-
Enucleation:- Is a surgical procedure that is used in case of large choroidal melanomas and tumors that have failed the conservative techniques.
Radioactive Plaque Brachytherapy:- Because of gradual cell turnover, melanomas are less radiosensitive as opposed to some other tumors, but many melanomas relapse adequately after radiotherapy. Plaque brachytherapy is used in the management of choroidal melanomas.
Charged Particle Radiotherapy:- Proton-beam therapy delivers a homogenous dose to the complete tumor. Brachytherapy, on the other hand, gives the tumor base several times the dose of the tumor apex.
Thermotherapy:- Thermotherapy is used for comparatively small choroidal melanomas and is considered a primary treatment with direct cytotoxic effect. It can also be used as an adjuvant agent to improve the efficiency of radiotherapy or chemotherapy by sensitizing tumor cells.