Choroidal melanoma

Choroidal melanoma is the most frequent intraocular tumor in adults. Due to its anatomic location the diagnosis often should be made on the basis of clinical examination and ancillary diagnostic procedures. The choroid melanoma may appear as a visual disturbance, retinal detachment and decrease of visual acuity. The diagnostic methods of choice are: Ultrasonography, Doppler, Ophthalmoscopy and Fluorescein Angiography, Computed Tomography and Magnetic Resonance Imaging (MRI) and are very useful in evaluating extra ocular extension of the tumor, post treatment local recurrence and differential diagnosis. Ultrasound is the primary method of diagnosis and follow up when a conservative treatment has been used, showing changes in vascularity and echogenicity. Magnetic resonance imaging is very useful in melanotic melanomas because the paramagnetic properties of melanine. They appear as areas of moderately high T1 signal and proton weighted MRI greater than vitreous and hypointensity in T2. The proper interpretation of its clinical presentation and the early use of imaging diagnostic methods allow a correct therapeutic approach and avoid local and distant metastasis which decrease survival time in these patients. (author)