Open-sky biopsy of ciliary body or choroidal tumors of undetermined origin: utility and safety

Purpose In the presence of a ciliary body or choroidal tumor of undetermined origin, an open-sky biopsy is performed in selected cases to establish a diagnosis and specify the therapeutic approach. We explored the frequency and reliability of this diagnostic procedure. Methods Retrospective, consecutive, histopathologic case series of 30 biopsies since 1989 of ciliary body or choroidal tumors of undetermined origin. Results Eighteen tumors originated from the ciliary body, 12 from the choroid. Diagnosis was respectively adenoma/adenocarcinoma (4;0), mesectodermal leiomyoma (4;1), metastatic tumor (2;0), melanocytic tumor (4;5), lymphoma (1;3); hemangioma (1;0) or posterior nodular scleritis (0;3). In 2 cases, there was insufficient material to make a diagnosis. There were no cases where the biopsy complicated local or systemic tumor control. Conclusion Open-sky biopsy is only performed in cases whose clinical appearance doesn’t permit to confidently establish a diagnosis; its goal is to guide the therapeutic approach.