Small Choroidal Melanoma

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Abstract
In this issueof theArchives, the Collaborative Ocular Melanoma Study (COMS) Group reports on factors that are predictive of growth and treatment of small choroidal melanomas based on data generated from their small-tumor observational study.1Their article sets the stage for an ongoing debate in the evaluation and management of patients with presumed small choroidal melanomas. Uveal melanoma is the most common primary intraocular malignant neoplasm in adults. The management of patients with this malignancy has been a topic of controversy for decades. In 1985 the National Eye Institute,joined by the National Cancer Institute in 1991, funded the COMS Group to evaluate the treatment of choroidal melanoma.2The COMS was structured in 3 protocols: 2 randomized clinical trials to evaluate treatment of medium and large choroidal melanomas and a third, nonrandomized study of small choroidal melanomas.3The large-tumor treatment trial compared fractionated external beam radiotherapy prior