Management of small

choroidal melanocytic tumour Papadopoulou et al1 are to be congratulated for submitting an informative article regarding the management of small chor-oidal melanoma with pertinent discussion and various educational points to remem-ber. We were, however, surprised, not to find the use of OCT (optical coherence tomography) as part of the management to help the diagnosis or in the discussion section. The authors1 correctly highlight the use of B-scan ultrasound to document the echographic features of melanocytic tumours; however, the use of OCT is com-plementary to human observation, echogra-phy and fluorescein angiography in cases of shallow subretinal fluid for multiple retinal pathology including small choroidal mela-nomas. Latest-generation OCT machines are quick, non-invasive and reliable with good reproducibility. With availability of enhanced depth-imaging mode, scanning of the choroid is now feasible. This has been well described by Shields et al,2–5 and we find their mnemonic TFSOM (presence of three or more features suggests high risk of small choroidal melanoma vs benign chor-oidal naevus) very useful for risk stratifica-tion in choroidal melanocytic tumours. (TFSOM=T, thickness>2.0 mm; F, subret-inal fluid; S, symptomatic; O, orange pig-mentation; M, margin touching the optic nerve.) Also the referral guidelines devel-oped by the ocular oncology group, for the Royal College of Ophthalmologists UK,6 recommend referral for specialist oncology opinion of any suspicious choroidal naevi>2.0 mm thickness or thickness>1.5 mm if associated with serous retinal detachment and orange pigment. OCT to detect serous retinal detachment (subretinal fluid) should be used to improve management of melano-cytic choroidal lesions