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23-25G Chandelier Assisted Biopsy of Choroidal Mass

  Channels: Retina | Posted 4/12/2017

Transillumination and indirect ophthalmoscopy are the two most commonly recommended methods for biopsy of choroidal mass. Both these approaches have a significant learning curve for localization, visualization and accurate acquisition of tissue sample. In the video that follows we describe a new approach for fine needle aspiration biopsy of choroidal mass using 23-25 trocar cannula, chandelier light and direct wide angle visualization under the microscope. This approach is like what all retinal surgeons perform routinely during vitreoretinal surgery. Hence there is no learning curve and tissue specimen can be obtained accurately under direct visualization. Passing the needle through the cannula may also eliminate the risk of tumor seeding in the needle track. In the first video, FNAB helped to confirm the clinical diagnosis of an inflammatory mass while the MRI diagnosis was melanoma. In the second patient, biopsy helped confirm amelanotic melanoma which is a rare diagnosis in our population.

Choroidal melanoma • Fine-needle aspiration biopsy, FNAB • Retina