Choroidal Melanoma: Clinical Features, Pathology and Diagnostic Approaches

Choroidal melanoma arises from melanocytes within the choroid and is the second most common intraocular malignancy in adults after metastasis. It is important to distinguish choroidal melanomas from nevi, which can range in color from amelanotic to darkly pigmented tumors. In this distinction, attention should be paid to the presence of a lesion thicker than 2 mm, larger than 5 mm, accumulation of lipofuxin pigment, subretinal fluid and exudative detachment. Symptoms vary depending on the location of the tumor but include decreased visual acuity, narrowing of the visual field, metamorphopsia, photopsia and floaters. It may cause death secondary to distant metastases (most commonly liver). Ultrasonography is the primary diagnostic test.