ABSTRACT

Purpose:

To report the outcomes of transretinal choroidal biopsy in choroidal melanoma without vitrectomy and tamponade.

Material & Methods:

Retrospective review of patients with choroidal melanoma treated with primary proton beam radiotherapy between 2011 and 2016 and who underwent a prognostic 25g transretinal biopsy without vitrectomy and tamponade. The main outcomes and measures were number of rhegmatogenous retinal detachments (RRD), tumour seeding and success of cytology and genetic studies.

Results:

Between September 2011 and February 2017, one hundred and five patients fulfilled the inclusion criteria, including a minimum follow-up of 12 months. Of these patients, 2 patients developed RRD, 1 secondary to a FTMH and in the other patient no retinal break was found. No cases of conjunctival tumour seeding were observed. No significant intra or post operative haemorrhage was noted. Histopathological examination confirmed diagnosis and genetic typing in 104/105.

Conclusions:

25G Transretinal biopsy without vitrectomy and tamponade is a safe and effective procedure for the diagnosis and prognosis of choroidal melanomas. Accurate survival prognostication for patients with uveal melanoma (UM) enables effective patient counselling and permits personalised systemic surveillance for the early detection of metastases and, in high-risk patients, enrolment in any trials of systemic adjuvant therapy. This is in contrast to merely treating the melanoma and offering 6 monthly liver ultrasounds to all patients which may place a burden on healthcare systems and subject the patient to unnecessary follow up appointments and investigations in the case of a low risk tumour. This technique can also be used in scenarios where the clinical diagnosis of a choroidal lesion is uncertain and carries minimal risk of complications.


CONTACT DETAILS

 

Lara SANDRI*, Rumana HUSSAIN, Carl GROENEWALD, Heinrich HEIMANN
St Pauls – Royal Liverpool Hospital
Liverpool
United Kingdom
Email : Lsandri@supernet.co.za
Cell Phone: +4427824681365
Work Phone: +4427118841440