The diagnosis of uveal malignant melanomas in eyes with opaque media.

Of 358 eyes enucleated between 1962 and 1975, and found to contain posterior uveal melanomas, 31 had opaque media (8.6%). Eighteen of these patients with opaque media were seen between 1962 and 1971, before the use of combined ultrasonography and the radioactive phosphorus uptake (32P) test. Melanoma was unsuspected at enucleation in one third of these patients and there was often a long delay in diagnosis. Of the 13 patients seen between 1971 and 1975, after the initiation of combined ultrasonography and 32P) test, there was no delay in diagnosis becuase a melanoma pattern was recognized immediately with ultrasonography and confirmed with a positive 32P test. During the latter part of this study, 19 patients with opaque media had a "melanoma pattern" with ultrasonography. The 32P test was positive in 12 cases and a melanoma was confirmed histologically in every instance. The 32P test was negative in seven cases and all were documented on follow-up to have benign lesions, such as subretinal hemorrhages.