phosphorus-radioisotopes and Choroid-Neoplasms

The most common primary ocular tumor in adults is malignant melanoma of the choroid. Metastatic tumors to the choroid occur with the same frequency. The radioactive phosphorous uptake test is used most often as a nuclear diagnostic test. The test does not differentiate melanomas from metastases, and it is necessary to perform surgery for proper placement of a detection device within a distance of 1-2 mm of the tumor. These deficiencies leave ophthalmologists with a pressing need for a gamma-emitting radiopharmaceutical that would facilitate noninvasive identification of choroidal melanoma. This need is made more urgent by the fact that recently, radiation therapy has been used to treat these tumors rather than enucleation. Eyes then harbor irradiated melanoma whose status is unknown. The tumor rarely decreases in size more than 25% to 50%. There is thus a need for a specific diagnostic test to assess the nature of the tumor and the effectiveness of therapy.

Topics: Choroid Neoplasms; Eye Neoplasms; Female; Gallium Radioisotopes; Humans; Iodine Radioisotopes; Melanins; Melanoma; Ophthalmology; Phosphorus Radioisotopes; Radioisotopes; Radiometry; Radionuclide Imaging

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Choroid Neoplasms; Ciliary Body; Eye Diseases; Eye Neoplasms; Female; Hemangioma; Humans; Infant; Infant, Newborn; Iris; Male; Melanoma; Middle Aged; Nevus; Phosphorus Radioisotopes; Pregnancy; Radionuclide Imaging; Retinoblastoma

Topics: Choroid Neoplasms; Diagnosis, Differential; Humans; Melanoma; Neoplasm Metastasis; Nevus, Pigmented; Phosphorus Radioisotopes

Results of the 32P uptake test for the diagnosis of choroidal melanoma in 41 patients are reported. The sensitivity was 80%, the specificity 86%, if a count rate ratio of more than 1.4 between tumor and normal tissue was considered as pathological. Ratios between 1.4 and 1.6 ought to be considered as equivocal in which case specificity increases to 90%. The 32P uptake test still remains a method of clinical relevance in the diagnosis of choroidal melanoma.

Topics: Choroid Neoplasms; False Negative Reactions; False Positive Reactions; Humans; Melanoma; Phosphorus Radioisotopes; Sensitivity and Specificity

Topics: Choroid; Choroid Neoplasms; Diagnosis, Differential; False Negative Reactions; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging; Uveal Diseases

The most frequently used radioisotope in ophthalmology is radioactive phosphorus (32P). Since its introduction into ophthalmology in 1951, it has been used primarily as an aid in the diagnosis of malignant melanoma of the choroid. During the thirty years of clinical use, the indications for this test have been clearly defined. The maximum tissue penetration of 32P is 7 mm. Surgical dissection is therefore frequently necessary to enable the ophthalmologist to place the Geiger-Muller probe on the sclera in proximity to the tumor. False positive and false negative results are unusual and the test is between 96% and 100% accurate.

Topics: Choroid Neoplasms; False Negative Reactions; False Positive Reactions; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging

The 32P uptake test used in the differential diagnosis of 912 cases yielded an accuracy rate of 94.82% for intraocular lesions behind the equator, and 85.15% for lesions of the anterior uvea. The highest error rate occurred in patients with suspected tumors of the iris and ciliary body. It seems advisable to take a 40% difference on the uptake as the limit between a positive or negative test result.

Topics: Adenoma; Choroid Neoplasms; Ciliary Body; Diagnosis, Differential; Eye Neoplasms; False Negative Reactions; False Positive Reactions; Humans; Iris Diseases; Melanoma; Phosphorus Radioisotopes; Retinal Hemorrhage; Sarcoma, Kaposi; Uveal Neoplasms

Topics: Choroid Neoplasms; Fluorescein Angiography; Humans; Melanoma; Phosphorus Radioisotopes

The ophthalmology radioactive phosphorus uptake test has been utilized in the differential diagnosis of intra ocular lesions in 21 patients. In the majority of the cases the diagnosis was histologically confirmed. When the lesion is located in the anterior part of the globe, it is not necessary to make an incision of the conjunctiva to perform the test. If the lesion is located in the posterior segment, the test is performed by the transscleral route, with surgical incision of the conjunctiva and with indirect ophthalmoscopy control when possible. In 3 patients with choroidal hemangioma were results false-positives, observed with inferior P32 uptake to that in patients with choroidal melanomas. One false-negative result was obtained in a patient with a clinical diagnosis of uveal malignant melanoma, histologically confirmed after enucleation of the globe. In all others patients with uveal malignant melanoma results were highly positive.

Topics: Choroid Neoplasms; Diagnosis, Differential; Diagnostic Errors; Eye; Eye Diseases; Eye Neoplasms; Hemangioma; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging

In vivo and in vitro measurements of radioactive phosphorus uptake after intravenous injection of P32 in 26 cases of malignant melanoma of the choroid is reported. The specific radioactivity of dissected ocular tissue after enucleation is described. No statistically significant relationship between the radioactive phosphorus uptake and the histologically differentiated cell type was found. It was possible to demonstrate the P32 uptake as a function of the mass of the tumor.

Topics: Choroid Neoplasms; Eye; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging

Values for radioactive phosphorus uptake from 23 eyes with malignant melanomas of the choroid were compared before and after enucleation. In all but two eyes, the percentage increase in 32P uptake was higher immediately after enucleation than before enucleation. In 11 eyes, the variation was more than 100%. In one eye, the percentage increase of 32P uptake was 68% before enucleation and 137% after enucleation. The clinical importance of our findings is that pressure on the globe by the detector probe before enucleation may locally decrease choroidal blood volume thereby causing an increase in the calculated 32P uptake.

Topics: Blood Volume; Choroid Neoplasms; Humans; Intraocular Pressure; Melanoma; Phosphorus Radioisotopes

Five eyes containing choroidal melanomas were found, on histopathologic examination, to have traumatic episcleritis with foreign-body granulomas and scleral edema underlying the area of tumor. This reaction was clearly correlated with phosphorus 32 testing that had been performed one to four weeks earlier. In all cases, enucleation had been delayed for logistic reasons. Invasion of the sclera or intrascleral canals was found in each case, with extension to the episclera in two of three small melanomas. Although the cases are few, this degree of invasion was greater than that seen in our other small melanomas or in reported series. The possibility that manipulation and inflammation of this type might have an adverse stimulatory influence on some melanomas should be considered when planning delayed enucleation after 32P testing. The juxtaposition of cautery marks and intrascleral tumor in a further case of melanoma demonstrates another possible complication of 32P testing.

Topics: Aged; Choroid Neoplasms; Female; Foreign-Body Reaction; Humans; Inflammation; Male; Melanoma; Middle Aged; Neoplasm Invasiveness; Phosphorus Radioisotopes; Radionuclide Imaging; Sclera

The concentration of radioactive phosphorus in uveal melanoma and normal parts of the eye was determined in vitro in 14 eyes. The eyes were enucleated after a positive 32P uptake test. Portions of the melanoma as well as normal choroid, retina, sclera, lens, and vitreous were analyzed. The 32P uptake test had been performed at various intervals after intravenous administration of 32P from 24 to 556 hr. The in vitro uptake of 32P was compared to cell type, tumor volume, time of testing, percent uptake measured clinically, and specific activity. The only positive correlation was between percent uptake measured clinically and 32P concentration (dpm/gm). A higher concentration of phosphorus in melanoma resulted when carrier-free 32P was used. A negative correlation existed between number of hours from injection to clinical measurement of percent uptake, although melanoma to normal choroid ratios did not change from 24 to 72 hr. No correlation was found between uptake and tumor volume. The sample was small; however, we saw no correlation between 32P uptake and degree of malignancy.

Topics: Aged; Choroid Neoplasms; Eye; Female; Humans; In Vitro Techniques; Male; Melanoma; Middle Aged; Mitosis; Ophthalmologic Surgical Procedures; Phosphorus Radioisotopes

Topics: Choroid Neoplasms; Fluorescein Angiography; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging; Serologic Tests; Ultrasonography

An infrared sensor was inserted at the film plane of a fundus camera. The signal was visualized on an oscilloscope. In this manner we measured infrared reflectance from the surface of the fundus. The purpose was to characterize choroidal malignant melanomas more reliably than is done with infrared color translation photography. Control lesions were choroidal nevi, metastatic tumors, and disciform macular degenerations. Correlations were made with radioactive phosphorus (32P) uptake, fluorescein angiography, and histopathologic findings. Several cases are presented, one in which this new method of infrared detection was the first diagnostic test to detect the spread of a choroidal melanoma. The simplicity of this technique and its increased accuracy justify the needed further refinements.

Topics: Adult; Aged; Choroid Neoplasms; Female; Fluorescein Angiography; Fundus Oculi; Humans; Infrared Rays; Macular Degeneration; Melanoma; Middle Aged; Neoplasm Metastasis; Nevus; Phosphorus Radioisotopes; Photography; Ultrasonography

Current follow-up information was obtained for 91 of 100 patients with tumors of the uveal tract for whom transscleral 32P tests had been performed and the eye had been enucleated because of malignant melanoma. The 32P uptake test was found to correlate better with outcome than either mitotic activity or invasion of the sclera. However, the correlation was not as good as that observed for tumor size and cell type. While most of the prognostic information in the 32P uptake value could be determined from the size of the tumor, none of the 13 tumors with 32P uptake less than 100% developed metastatic melanoma. The amount of necrosis within the tumor correlated with a bad prognosis and lower 32P uptake. There were three cases of spindle-cell nevi, all with positive 32P uptake values and none with metastasis.

Topics: Choroid Neoplasms; Follow-Up Studies; Humans; Melanoma; Neoplasm Metastasis; Phosphorus Radioisotopes; Prognosis

The radioactive phosphorus (32P) uptake test used in ocular tumor evaluation in 408 cases achieved an overall percentage error rate of 3.6%. This compared favorably with the clinical error rate of 19.2% overall. The least accuracy was obtained in cases with ciliary body lesions.

Topics: Adolescent; Adult; Aged; Child; Choroid Neoplasms; Eye Neoplasms; False Negative Reactions; False Positive Reactions; Female; Humans; Male; Melanoma; Middle Aged; Nevus, Pigmented; Phosphorus Radioisotopes; Uveal Neoplasms

A report on results of 186 32P tests is given. Radiation increases of more than 30%, compared with tumor-free areas, were considered as positive. 95 eyes were histologically examined. The 32P test gave 90 correct positive answers and 1 correct negative answer. Faulty positive results were found in 2 cases; faulty negative results were also found in 2 cases. This means that the diagnosis was correct in 95%. The literature is discussed concerning reliability and methods. The dangers of the use of 32P are stressed, and the development of noninvasive nuclear-medical diagnostic methods is suggested.

Topics: Choroid Neoplasms; Ciliary Body; Diagnosis, Differential; Eye Neoplasms; Humans; Iris; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging; Uveal Neoplasms

Topics: Choroid Neoplasms; False Negative Reactions; False Positive Reactions; Hemangioma; Humans; Melanoma; Neoplasm Metastasis; Nevus; Ophthalmologic Surgical Procedures; Phosphorus Radioisotopes; Radionuclide Imaging

Handle probe and counting system for radiophosphorus test can be checked by the use of a 64 nCi Strontium-90 radiator established inside a plexiglas cylinder. Counting system adjustment to 40 dB amplifier and 0.70 discriminator resulted in 1710cpm+/-2% standard deviation. This check method is suitable for controlling the counting system before tumor measurement. Advantages of this test method are low expenses, stability of the radionuclide, and riskless use of beta-radiator.

Topics: Choroid Neoplasms; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging; Scintillation Counting

Choroidal hemangioma, a benign vascular tumor of the choroid, can frequently develop an effusive secondary retinal detachment. When such retinal detachment involves the macula, reduction in central vision occurs. Fluorescein angiography and radioactive prosphorus tests are helpful in accurately diagnosing choroidal hemangioma. Transscleral cryopexy, freeze-thaw-refreeze method, results in complete destruction and scarring of the choroidal hemangioma. Following treatment, subretinal fluid disappears, the macula becomes reattached, and central vision is restored.

Topics: Adult; Choroid Neoplasms; Cryosurgery; Fluorescein Angiography; Follow-Up Studies; Hemangioma; Humans; Macula Lutea; Male; Phosphorus Radioisotopes; Retinal Detachment; Scotoma

We compared 19 choroidal hemangiomas and 21 choroidal melanomas of comparable size as to the percent of radioactive phosphorus 32P uptake. The results were significantly lower in choroidal hemangiomas than in comparable sized melanomas.

Topics: Choroid Neoplasms; Diagnosis, Differential; False Positive Reactions; Hemangioma; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging

The author reports about the radio-phosphorus-test as an additional method in diagnostics of intraocular tumors in 62 examinations. The conformity between 49 histologically examined cases and the positive test-results amounted to 90%.

Topics: Choroid Neoplasms; Eye Neoplasms; Humans; Melanoma; Methods; Phosphorus Radioisotopes; Radionuclide Imaging

Topics: Adult; Child; Choroid Neoplasms; Fluorescein Angiography; Hemangioma; Humans; Infrared Rays; Ophthalmoscopy; Phosphorus Radioisotopes; Photography; Radiography; Sturge-Weber Syndrome; Transillumination; Ultrasonography

An amelanotic fundus lesion in a 35-year-old man was associated with a dilated retinal vessel, thus suggesting the diagnosis of retinal angioma. Fluorescein angiography and B-scan ultrasonography were not diagnostic, but a radioactive phosphorus uptake test suggested the lesion was malignant. The enucleated globe showed a malignant choroidal melanoma drained by a large retinal vein.

Topics: Adult; Choroid Neoplasms; Ciliary Body; Diagnosis, Differential; Eye Neoplasms; Fluorescein Angiography; Hemangioma; Humans; Male; Melanoma; Nerve Fibers, Myelinated; Phosphorus Radioisotopes; Retina; Retinal Vessels

We studied four patients with posterior brawny scleritis. Two underwent enucleation for suspected melanoma, and in the other two, the correct diagnosis was made and effective therapy begun. Of seven other eyes with brawny scleritis from other sources, five were enucleated after diagnosis of choroidal melanoma and one for suspected intraocular tumor. This experience and other previous reports indicate the high incidence of diagnostic confusion regarding brawny scleritis. We therefore emphasized clinical symptoms and signs of brawny scleritis: inflammation, tenderness or pain of the globe, history of collagen vascular disease, proptosis, bilaterality, and retinal and choroidal detachment. A preserved normal choroidal vascular pattern over an elevated subretinal mass may be indicative of posterior brawny scleritis. Scleral biopsy is useful for tissue diagnosis. Radioactive phosphorus uptake tests and ultrasonography may erroneously indicate choroidal melanoma and lead to enucleation of a potentially salvageable globe.

Topics: Adult; Aged; Choroid Neoplasms; Diagnosis, Differential; Diagnostic Errors; Exophthalmos; Female; Humans; Inflammation; Male; Melanoma; Middle Aged; Pain; Phosphorus Radioisotopes; Retinal Detachment; Sclera; Ultrasonography

We report the clinical and histopathologic features of an osseous choristoma of the choroid that appeared in a 26-year-old woman. Her diagnostic evaluation included a radioactive phosphorus (32P) uptake test, which was 270% positive and led us to believe that the lesion was an atypical malignant melanoma. The extent of true ossification within this tumor, seen microscopically, explains the false-positive uptake of radioactive phosphorus by this benign tumor; it is well known that bone avidly accumulates radioactive phosphorus. We recommend that all "atypical choroidal melanomas" be studied for the presence of bone, with bone-free roentgenograms, ultrasonography, and possibly, computerized tomographic scans before 32P testing or enucleation. This, to our knowledge, is the second histopathologically proved case of an osseous choristoma of the choroid to be reported in the literature.

Topics: Adult; Bone and Bones; Choristoma; Choroid Neoplasms; Diagnosis, Differential; Female; Fluorescein Angiography; Humans; Melanoma; Phosphorus Radioisotopes

The accurate and early diagnosis of intraocular malignant melanoma in eyes with opaque media remains a diagnostic problem. Ultrasonography and the radioactive phosphorus (32P) uptake test have been used separately as modalities for diagnosis of choroidal melanoma. However, their combined use has received limited attention. This report presents our experience in 5 cases with the combined use of a contact B-scan ultrasound unit and a posterior eye probe. In all cases we were able to accurately perform the 32P uptake test with simultaneously ultrasound visualization of the tumor and the probe.

Topics: Aged; Catheterization; Choroid Neoplasms; Female; Fluorescein Angiography; Humans; Male; Melanoma; Middle Aged; Phosphorus Radioisotopes; Retinal Diseases; Ultrasonics; Ultrasonography

Three patients had suspected choroidal melanoma and positive results for radioactive phosphorus (32P) uptake tests, leading to enuclearion in two of the patients. No malignancy was present on histopathologic examination. This experience reemphasizes the need for the ophthalmologist to evaluate the total clinical picture and not to give inappropriate consideration to a "positive" 32P uptake test in deciding for or against enucleation in a suspected choroidal melanoma. The positive 32P uptake test, even with high values, cannot be equated with malignancy, and a variety of nonmalignant lesions may give false-positive results.

Topics: Adult; Choroid Neoplasms; Diagnostic Errors; Evaluation Studies as Topic; Female; Humans; Melanoma; Middle Aged; Phosphorus Radioisotopes; Sclera

Topics: Adolescent; Choroid Neoplasms; Ciliary Body; Conjunctiva; Diagnosis, Differential; Diagnostic Errors; Evaluation Studies as Topic; Eye Neoplasms; Humans; Iris; Lymphoma; Melanoma; Neoplasm Metastasis; Phosphorus Radioisotopes; Retinoblastoma

Topics: Choroid Neoplasms; Female; Hemorrhage; Humans; Melanoma; Middle Aged; Phosphorus Radioisotopes

Many of the difficulties in diagnosing choroidal melanomas which confronted clinicians in the past have now been eliminated. This is due to greater clinical awareness of melanomas and pseudomelanomas, as well as the use of indirect ophthalmoscopy and other ancillary tests. With further investigation, other diagnostic techniques may be developed for clinical use.

Topics: Choroid Neoplasms; Eye Neoplasms; Fluorescein Angiography; Humans; Melanoma; Phosphorus Radioisotopes; Transillumination; Ultrasonography; Uveal Diseases

A chorioretinal granuloma that contained acid-fast bacilli and a choriodal nevus that consisted of benign nevus cells yielded false-positive radioactive phosphorus tests. The beta emission exceeded that of the control areas by more than 100% in each case. The granuloma had infiltrated the sclera, permitting inflammatory tissue to be in closer proximity to the counting probe than was the normal choroid. The reason for the increased metabolic activity of the nevus cells remains unexplained.

Topics: Adult; Aged; Choroid; Choroid Neoplasms; False Positive Reactions; Female; Fluorescein Angiography; Granuloma; Humans; Male; Melanoma; Phosphorus Radioisotopes; Retinal Diseases; Ultrasonography; Uveal Diseases

The radioactive phosphorus uptake of 30 samples fron nine uveal melanomas was determined by liquid scintillation counting. These in vitro measurements correlated positively with clinical (in vivo) 32P values and with the number of mitotic figures and percentage of epithelioid cells (PEC) within the specimens. Three possible explanations were found for the failure of previous workers to demonstrate a correlation between cell type and clinical 32P. (1) Cell type, using Callender's classification, provides only a crude estimate of the PEC within a tumor; in particular, tumors of mixed cell type can vary widely in epithelioid cell content. (2) The rate of 32P absorption is not su-ficiently sensitive to distinguish spindle cell tumors from mixed cell tumors with a low PEC. (3) Clinical 32P measurements may be affected by extraneous factors that cause large deviations from the expected values.

Topics: Choroid Neoplasms; Ciliary Body; Eye Neoplasms; Humans; In Vitro Techniques; Melanoma; Phosphorus Radioisotopes; Scintillation Counting

Results from a 32P test in a histologically proven choroidal hemangioma were normal in a case we recently evaluated. It is believed that this case is important because of the infrequent number of confirmations with this test.

Topics: Adult; Choroid Neoplasms; Diagnosis, Differential; Female; Hemangioma; Humans; Melanoma; Phosphorus Radioisotopes

The ultrasonic examination gives no answer as to the metabolic activity of pathological intraocular tissue. Therefore, the combination with the 32P uptake test is great clinical value. The diagnosis of intraocular tumors is possible with a 95% certainty. A new probe with a Si(Li) semiconductor detector is presented.

Topics: Choroid Neoplasms; Ciliary Body; Eye Neoplasms; Humans; Melanoma; Phosphorus Radioisotopes; Semiconductors

Topics: Choroid Neoplasms; Humans; Melanoma; Phosphorus Radioisotopes; Time Factors

A malignant melanoma of the choroid presented with a massive vitreous hemorrhage which prevented any view of the posterior pole. The diagnosis was confirmed by the results of a radioactive phosphorus test and ultrasonography. In eyes with opaque media, these tests will ofter prevent delays in diagnosis.

Topics: Aged; Choroid; Choroid Neoplasms; Eye Diseases; Hemorrhage; Humans; Male; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging; Ultrasonography; Vitreous Body

Topics: Choroid Neoplasms; Eye Neoplasms; Humans; Phosphorus Radioisotopes

Topics: Choroid Neoplasms; Diagnosis, Differential; Diagnostic Errors; Eye Neoplasms; False Negative Reactions; False Positive Reactions; Hemangioma; Humans; Melanoma; Methods; Phosphorus Radioisotopes; Uvea

Two false-negative results from 32P testing for histologically verified malignant melanomas of the choroid are reported. In the first case, a haemorrhagic choroidal detachment caused an increase in probe; additionally, the tumour was necrotic. Both factors are likely to have contributed to the false-negative result. A satisfactory explanation for the false-negative result in the second case was not determined, although it may have accurately reflected a period of minimal tumour activity, inasmuch as repeat 32P testing was strongly positive eight months later, when unequivocal evidence of tumour growth was present. An alternative explanation is that the orally administered 32P was incompletely absorbed. Since 32P testing is frequently accompanied by significant manipulation both in the manoeuvre associated with tumour localization and in that associated with the actual radioactive counting, it would seem desirable to perform indicated enucleation immediately after completion of the 32P testing. While the properly performed 32P test remains a valuable diagnostic test for helping to establish the presence or absence of malignancies of the posterior globe, it is important to guard against the tendency to underestimate careful clinical evaluation.

Topics: Aged; Choroid Neoplasms; False Negative Reactions; Female; Humans; Melanoma; Phosphorus Radioisotopes; Retinal Detachment

Twenty-nine patients who had undergone enucleation for ocular malignant melanoma were studied. The results of the radioactive phosphorus uptake (32P) tests were correlated with histopathologic observations. There was a positive correlation between the 32P test results and the histologic degree of malignancy. Mixed cell melanomas were more frequent in the patients ranked with higher 32P test results. Spindle cell melanomas occurred more frequently in patients with lower 32P test results. Mitoses per field and degree of malignancy correlated positively with 32P test results when ranked in a masked manner by two ocular pathologists. Tumor volume and clinical factors did not correlate with the 32P test results. While patients with mixed cell melanomas had higher mean 32P test results than those with spindle cell melanomas, a large variance was noted. Because of this the 32P test is unreliable in predicting the histopathology of a tumor in individual cases.

Topics: Aged; Choroid Neoplasms; Ciliary Body; Eye Neoplasms; Female; Humans; Male; Melanoma; Middle Aged; Phosphorus Radioisotopes; Prognosis; Uvea

Topics: Choroid Neoplasms; Fluorescein Angiography; Humans; Phosphorus Radioisotopes; Radionuclide Imaging; Thermography; Transillumination; Ultrasonography

Topics: Choroid Neoplasms; Humans; Melanoma; Ophthalmology; Phosphorus Radioisotopes; Technology, Radiologic

A 57-year-old white woman presented with a small malignant melanoma of the choroid in the macular area of the right eye. The lesion failed to produce a visual field defect or to show fluorescence with angiography, but the radioactive phosphorus uptake(P) test was positive. Histologically, the retinal pigment epithelium was intact over the tumor and the sensory retina was normal. This unusual finding was the most likely explanation for the normal visual field. The intact retinal pigment epithelium over this nonfluroescent melanoma suggests that the destruction of the retinal pigment epithelium occurring with most choroidal melanomas may partially explain why these tumors usually demonstrate fluorescence. This case emphasizes the great accuracy of the P test for diagnosing small malignant tumors of the choroid, even before other popular diagnostic modalities indicate the malignancy of the lesion.

Topics: Choroid; Choroid Neoplasms; Female; Fluorescein Angiography; Fluorescence; Humans; Melanoma; Middle Aged; Ophthalmoscopy; Phosphorus Radioisotopes; Photomicrography; Retina; Ultrasonography

Topics: Choroid Neoplasms; Humans; Melanoma; Phosphorus Radioisotopes; Statistics as Topic

Topics: Adolescent; Adult; Choroid Neoplasms; Diagnosis, Differential; Female; Humans; Male; Melanoma; Middle Aged; Neoplasm Metastasis; Phosphorus Radioisotopes

Topics: Choroid Neoplasms; Hemangioma; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging; Technetium

Topics: Choroid Neoplasms; Diagnostic Errors; Humans; In Vitro Techniques; Melanoma; Phosphorus Radioisotopes

Topics: Adult; Aged; Choroid Neoplasms; Cobalt Radioisotopes; Dose-Response Relationship, Radiation; Female; Humans; Light Coagulation; Macula Lutea; Male; Melanoma; Methods; Middle Aged; Phosphorus Radioisotopes; Radioisotopes; Radiotherapy; Radiotherapy Dosage; Rhodium; Ruthenium; Visual Acuity

Topics: Adult; Age Factors; Aged; Choroid Neoplasms; Ciliary Body; Diagnosis, Differential; Diagnostic Errors; Eye Diseases; Eye Neoplasms; Female; Glaucoma; Humans; Male; Melanoma; Middle Aged; Ophthalmia, Sympathetic; Phosphorus Radioisotopes; Radionuclide Imaging; Transillumination; Uvea

Topics: Choroid; Choroid Neoplasms; Humans; Melanoma; Phosphorus; Phosphorus Radioisotopes

Topics: Choroid; Choroid Neoplasms; Humans; Melanoma; Phosphorus; Phosphorus Radioisotopes; Phosphorus, Dietary