Abstract
Accurate differentiation between benign and malignant choroidal and retinal lesions is crucial for selecting optimal treatment and management strategies. Multimodal imaging plays an essential role in confirming diagnoses, monitoring lesions for changes such as progression, regression, or recurrence, and identifying potential complications. While fundus photography captures key clinical features of retinal and choroidal lesions—such as color, size, and location—additional imaging techniques offer valuable insights into signs of chronicity, intrinsic vascularity, relationships with adjacent ocular structures, and malignancy risk factors. Ultra widefield (UWF) imaging is particularly effective in detecting peripheral lesions that might otherwise remain unnoticed. For conditions such as choroidal metastases, melanomas, and hemangiomas, UWF imaging provides detailed information about the size, shape, and precise location of lesions, as well as associated characteristics including subretinal fluid, hemorrhages, and exudation. This comprehensive perspective is critical for accurate staging, designing treatment plans, and monitoring therapeutic responses over time. Furthermore, UWF imaging enhances the detection of early signs of lesion recurrence or progression, enabling timely medical intervention. This chapter discusses a range of neoplastic conditions, encompassing benign lesions, intraocular malignancies, and paraneoplastic syndromes.