To biopsy or not to biopsy?

Transretinal uveal melanoma biopsy with 25‐gauge vitrectomy system

“…Clinical diagnosis supplemented by noninvasive techniques, such as diagnostic ultrasonography and fluorescein angiography, is now supposed to be >95% accurate for uveal melanoma and, according to the extensive Collaborative Ocular Melanoma Study Group (1990), >99% accurate for large uveal melanoma (Seregard 2009). In cases of atypical tumours, or at the patient’s request, a positive tissue diagnosis is necessary (Chan et al.…”

Diagnostic Cytologic Features of Uveal Melanoma

“…It is worth emphasizing that a negative cytologic diagnosis of malignancy should not be considered unequivocal proof that an intraocular malignancy does not exist. 8,13,17 As FNAB gains popularity with an improved safety profile, techniques, and instrumentation, there is a need to develop descriptive cytologic diagnostic features of uveal melanoma. 18e20 Because cytologic diagnosis is predominantly morphologically driven, automated digital methods that can identify, quantify, and characterize spindle cells in an ocular FNAB cytopathology slide can be developed for computer-assisted diagnosis.…”

Minimally invasive anterior orbitotomy biopsy: Finger's aspiration cutter technique (FACT)

“…For example, in 2007 the Swedish Cancer Registry reported that nearly 99% of primary malignant extraocular tumor diagnoses were assisted by a cytology or histopathology (1). In order to obtain such specimens, orbital surgeons must either approach by fineneedle aspiration biopsy (FNAB) or surgical orbitotomy (2)(3)(4)(5)(6)(7)(8). In general, when using an anterior or lateral approach, orbitotomy is a reasonably invasive procedure that requires a relatively large incision, tissue rearrangement, and at least temporary loss of function.…”