To the Editor.
—In their recent article in the Archives, "Spontaneous Regression of a Choroidal Melanoma," Lambert et al1 present a case report of a patient seen over a 15-year period. It is possible that this case represents a neoplasm that has spontaneously reabsorbed, but there are other more likely explanations; for example, changes in the choriocapillaris, Bruch's membrane, and retinal pigment epithelium routinely occur over malignant melanomas. An atrophiclooking scar is not infrequently seen adjacent to or on top of melanomas. The photographs taken in 1970 could represent a serous or hemorrhagic detachment of the retinal pigment epithelium on top of the tumor. Subsequent resolution of the detachment would produce the atrophic scar seen in the 1979 photograph. The finding of a lymphocytic response is not uncommon in choroidal melanomas (25% incidence)2 and certainly does not prove spontaneous regression.The appearance of choroidal melanomas in fundus photographs
Davidorf FH. Spontaneous Regression of a Choroidal Melanoma?. Arch Ophthalmol. 1986;104(9):1272-1273. doi:10.1001/archopht.1986.01050210026005