Small Choroidal Melanoma - Courtney Croley - 2025 05 09 скачать в хорошем качестве

Small Choroidal Melanoma - Courtney Croley - 2025 05 09

In this case presentation, Dr. Courtney Croley reviews the evaluation and management of a suspicious choroidal lesion in a 28-year-old man with a 15-month history of subfoveal pigment and subretinal fluid initially treated as a presumed neovascular process. Referral for a second opinion revealed key features concerning for a small choroidal melanoma, including lesion growth, orange pigment, subretinal fluid, and acoustic hollowness on ultrasound. The case underscores the diagnostic challenge of distinguishing small melanomas from nevi and highlights the use of multimodal imaging including OCT, fundus autofluorescence, ultrasound, and fluorescein angiography. Dr. Croley walks through the diagnostic criteria for small choroidal melanomas—summarized by the helpful mnemonic “To Find Small Ocular Melanoma Using Helpful Hints Daily”—and reviews updated risk stratification, histopathologic classifications, and the evolving management options from observation to brachytherapy and proton beam radiation. The talk also covers prognostic features and the high risk of hepatic metastasis, even in young patients, emphasizing the importance of early recognition and appropriate referral. This presentation is a valuable learning case for residents, retina specialists, and ocular oncologists managing melanocytic lesions in younger patients.