To the Editor.
—Wagoner and Albert have reported in the June Archives (1982;100:939-940) that 29 of 1,214 patients with melanomas of the choroid and/or ciliary body had metastases that were detected clinically prior to surgical manipulation of the globe, an incidence of 2.47% (the accurately calculated figure should be 2.39% rather than 2.47%!). We have two main reasons for believing that this figure could be an inflated estimate of the true incidence.The first is the method used for gathering data. The authors sent questionnaires to ophthalmologists requesting information concerning their personal experience. These contributors of data were distributed throughout the United States. They supplied the medical records of patients they had clinically judged to have uveal melanomas requiring therapy and on whom certain minimal liver-function studies had been made preoperatively. We believe that retrospective studies of this type are almost certainly going to be biased by the selection of
Lorenz E. Zimmerman, Ian W. McLean. Pretreatment Metastases in Patients With Ocular Melanomas. Arch Ophthalmol. 1983;101(4):665–666. doi:10.1001/archopht.1983.01040010665032