Dr. Vishal Raval

, Dr. NISHIN TEJA GUNNA

Abstract

A 32-year-old male presented with a sudden painless decrease in vision in his right eye for one month. Fundus examination showed a medium-size pigmented choroidal lesion 12 x 8 x 7 mm in size nasal to the disc with overlying retinal hemorrhage and surrounding exudative fluid. B-scan ultrasonography revealed an elevated choroidal lesion highly suggestive of choroidal melanoma. Considering the patient had near normal visual acuity, a fine needle aspiration biopsy was performed which confirmed the diagnosis of choroidal lesion of melanocytic origin. This video demonstrates a unique surgical endoresection of choroidal melanoma using a 25G vitrectomy system along with endolaser to tumor bed with silicone oil tamponade.

Endoresection can be an effective eye salvage method for the management of solitary choroidal melanoma, especially medium-size where brachytherapy is not possible. Pre and post-systemic surveillance are necessary, along with careful follow-up to detect any local recurrence.