June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
FNAB of Uveal Melanoma : Outcomes and Complications
Author Affiliations & Notes
  • Arun D Singh
    Ophthalmic Oncology, Cole Eye Institute, Cleveland, OH
  • Carlos A Medina Mendez
    Case Western Reserve University, Cleveland, OH
  • Nakul Singh
    Case Western Reserve University, Cleveland, OH
  • Mary E Aronow
    WIlmer Eye Institute, Baltimore, MD
  • Hassan A Aziz
    Ophthalmic Oncology, Cole Eye Institute, Cleveland, OH
  • Charles V Biscotti
    Anatomy PAthology, Cleveland Clinic, Cleveland, OH
  • Footnotes
    Commercial Relationships Arun Singh, None; Carlos Medina Mendez, None; Nakul Singh, None; Mary Aronow, None; Hassan Aziz, None; Charles Biscotti, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 4333. doi:
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      Arun D Singh, Carlos A Medina Mendez, Nakul Singh, Mary E Aronow, Hassan A Aziz, Charles V Biscotti; FNAB of Uveal Melanoma : Outcomes and Complications. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4333.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To report outcomes and complications of diagnostic fine-needle aspiration biopsy (FNAB) of uveal melanoma.

Methods: Prospective interventional series of 150 consecutive patients with uveal melanoma treated at the Cleveland Clinic Cole Eye Institute between May 2009 and August 2012. The FNAB approach (trans corneal [TCO], trans scleral [TSC], and trans vitreal [TSV] were primarily determined by the location of the tumor. The FNAB was performed using 25 Gauge needle using previously published technique. All aspirated material was flushed into in Cytolyt® solution for ThinPrep® processing. The diagnosis of uveal melanoma was based upon characteristic cellular features. The cytological reporting was divided into 4 conventional categories: 1. Unsatisfactory for interpretation, 2. Negative for melanoma, 3. Atypical cells (not diagnostic or consistent with melanoma) and 4. Positive for melanoma. Patients were evaluated 1-4 weeks postoperatively, then every 3 months for the first year, followed by every 6 months thereafter. Data were analyzed using STATA version 11.

Results: FNAB was obtained via TCO (8), TSC (71), and TVT (64) approach and impression smear in 7 cases. Diagnostic yield was 92% (Positive for melanoma 122, Atypical cells : consistent with melanoma 9). False negative results were oserved in 8% (Unsatisfactory 7, Negative for melanoma 3, Atypical cells : not diagnostic 2). Diagnostic yield was significantly correlated to biopsy approach (TCO 100%, TSC 96%, 86%; p = 0.029, Fisher’s exact test) and tumor size (basal diameter >5.0 mm; height >2.5 mm). Visual acuity (<20/40 and > 20/400) at baseline and at 3 months was recorded in 68%,13% and 57%, 22% respectively). Visually significant complications such as persistent hemorrhage (sub retinal hemorrhage or vitreous) requiring surgical intervention (1%) and rhegmatogenous retinal detachment (1%) were rare. Endophthalmitis, hypotony, and detectable needle tract seeding were not observed.

Conclusions: FNAB for uveal melanoma with 25-gauge needle is a safe procedure that can yield diagnostic samples in more than 90% of cases. Possibility of negative diagnostic FNAB yield should be considered when counseling patients with small tumors.

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