Fluorescein angiography of choroidal malignant melanomas with retinal invasion.

The authors reviewed the fluorescein angiograms of 99 choroidal malignant melanomas to determine the frequency of several angiographic abnormalities and the effectiveness of fluorescein angiography in identifying retinal invasion by the tumor. They identified a "double circulation" pattern in 60 of the 99 cases, broadened intercapillary spaces in 54, large zones of retinal capillary obliteration or obscuration in 35, blockage or obscuration of the larger caliber blood vessels overlying the tumor in 25, and tumororetinal vascular anastomoses in 15. Twelve of the 13 eyes in which they identified fluorescein angiographic abnormalities that they interpreted as evidence of definite or probable retinal invasion and that came to enucleation shortly after the angiography were confirmed to have retinal invasion histopathologically. Awareness of the fluorescein angiographic features indicative of retinal invasion may increase the frequency with which this manifestation of choroidal malignant melanomas is recognized.