A total of 1,398 consecutive enucleations performed at Wills Eye Hospital between 1962 and 1972 were reviewed. There were 188 eyes containing a visible fundus lesion which prompted enucleation because of a suspected malignant melanoma. On histologic examination, seven of these eyes (3.7%) were found to harbor a simulating lesion, rather than a melanoma. During the last six years of this study such simulating lesions were present in only two of 103 enucleated eyes, or 1.9%.
Several factors accounted for the decreased incidence of eyes enucleated for such simulating lesions. The most important factor was careful clinical observation, but other diagnostic adjuncts were useful in arriving at the diagnosis. In order to prevent unnecessary enucleations, it is recommended that every patient with a suspected fundus lesion be managed by the approach outlined.
Shields JA, McDonald PR. Improvements in the Diagnosis of Posterior Uveal Melanomas. Arch Ophthalmol. 1974;91(4):259-264. doi:10.1001/archopht.1974.03900060269004