Abstract
BACKGROUND: Early and accurate diagnosis of choroidal tumors including benign nevi, melanomas, and vascular lesions is essential for effective clinical management. Conventional imaging techniques such as fundus photography, optical coherence tomography, fundus autofluorescence, and ultrasonography have greatly advanced the accuracy of choroidal tumor assessment but do have limitations. Hyperspectral imaging (HSI) is a noninvasive modality capturing high-resolution spectral data across multiple wavelengths and has shown promise in various medical fields. Its emerging use in ophthalmology may offer novel insights, although clinical evidence remains preliminary. SUMMARY: This review explores the principles of HSI and its early investigational role in ocular oncology. Although clinical evidence remains limited, HSI may help improve lesion differentiation, tumor margin delineation and potentially provide indirect biochemical insights. When combined with existing imaging techniques, HSI could support a more comprehensive and individualized diagnostic approach. Key challenges and future directions are discussed. KEY MESSAGES: HSI is a promising, noninvasive imaging innovation with potential to enhance choroidal tumor characterization. While still primarily investigational, further clinical validation is essential to determine its role in ophthalmic practice.