[Indocyanine green angiography in choroid metastases]. / Indocyaningrün-Angiographie bei Aderhautmetastasen.

BACKGROUND: Up to now the diagnosis of choroidal tumors was mainly based on ophthalmoscopy and ultrasound examination. Indocyanine green angiography allows the identification of vascular patterns in these tumors, which could be helpful in the differential diagnosis. The aim of the study was to characterize the staining patterns of choroidal metastases. METHODS: In the years 1996-2000 we performed ICG-A of 15 choroidal metastasis using the scanning laser ophthalmoscope from Rodenstock. The mean tumor height was 3.7 mm (2.0-9.0). These angiographies were compared to the angiographies of 38 choroidal malignant melanomas with a mean height of 3.6 mm (1.4-6-6). RESULTS: All metastases showed a blockage of the background staining and a patchy staining of the tumor surface. Intratumoral vessels could be detected in 13% of all cases of metastases. The choroidal melanomas examined showed a blockage of the background staining in all cases and tumor vessels in 89%. CONCLUSION: The angiographic picture of the metastatic lesions was characteristic. Intratumoral vessels could not be detected using ICG-A. Most of the metastases showed a patchy staining of the tumor surface.

[Choroid melanoma. Adjuvant therapy in high risk patients and new therapy approaches in the metastatic stage]. / Aderhautmelanom. Adjuvante Therapie bei Hochrisikopatienten und neue Therapieansätze im metastasierten Stadium.

The treatment modality of primary uveal melanoma has up to now had no direct influence on the evolution of metastatic disease. Novel adjuvant treatment modalities are being developed on the basis of identifying significant prognostic factors for survival. The development of vaccination protocols targeting specific melanoma and/or tumor antigens has gained increasing importance and is currently being evaluated. Up to date the median survival of patients with metastases of uveal melanoma used to be approx. 5 months. In the last years median survival of selected patients with metastatic disease could be increased to 14 months by intrahepatic fotemustin influsions. Novel systemic chemotherapy protocols are currently being evaluated based on chemosensitivity studies. Furthermore, immunotherapeutical modalities are entering clinical evaluation as treatment for metastatic uveal melanoma.