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As many as 20% of uveal melanoma–containing eyes historically had opaque media and more than half of such tumors were unsuspected.1,2 While many ophthalmic oncologic centers, including ours, have more than 99% accuracy of uveal melanoma diagnosis, in eyes with opaque media and extensive necrosis the correct diagnosis can sometimes be impossible to establish with ultrasonography, magnetic resonance imaging (MRI), and fine-needle aspiration biopsy (FNAB).3,4 We present 5 cases that illustrate these problems.
Char DH, Cole TB, Crawford JB. Management of Occult Necrotic Melanomas. JAMA Ophthalmol. 2013;131(8):1067-1069. doi:10.1001/jamaophthalmol.2013.231