Choroidal neovascularization induced by transcleral microdiathermy for localization of a juxtapapillary choroidal melanoma

Transcleral transillumination is a useful tool for the localization of juxtapapillary uveal tract tumors that do not cast a shadow with conventional transpupillary transillumination. The main choice of treatment for juxtapapillary uveal tract melanoma consists of either episcleral plaque brachytherapy or proton beam radiotherapy. In both instances, an external surgical approach is required that involves localization of the tumor and marking of the overlying sclera. Transcleral microdiathermy often creates corresponding areas of chorioretinal atrophy. This article describes the technique of transcleral transillumination coupled with microdiathermy to mark the sclera in a patient in whom a choroidal neovascular membrane developed adjacent to a microdiathermy-induced area of chorioretinal atrophy after the described surgical technique. To avoid the postoperative development of a choroidal neovascular membrane, transcleral transillumination can be used without the application of microdiathermy.