The Role of Biopsy for Intraocular Tumors
Biopsy is commonly performed for most malignancies. However due to certain known and potential unknown risks of biopsy, coupled with advances in ophthalmic diagnostic techniques, most intraocular tumors are currently diagnosed by ophthalmoscopy (looking into the eye) coupled with ultrasound imaging and vascular studies (e.g. fluorescein angiography). In fact, the Collaborative Ocular Melanoma Study (COMS) found a 99.6% correct diagnosis rate without biopsy for selected tumors. On the other hand, if possible, all ocular tumor specialists would prefer to have a risk free confirmation of their clinical diagnosis by pathology.
Over the last 4-years there has been increased interest in genetic evaluation of choroidal melanoma. This has prompted renewed interest in obtaining tissue to determine the genetic profile of each tumor. The link below contains an interview of 4 leading eye cancer specialists from the USA and England. As you will read, there exists considerable controversy as to the clinical indications and necessity for these procedures. Like most surgeries, there are both risks and benefits. The editor of The Eye Cancer Network thought you might be interested in these opinions>
Paul T Finger, MD
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