Despite the abundance of publications, the interpretation of imaging techniques such as optical coherence tomography (OCT) remains challenging in the differential diagnosis of intraocular tumors (IOTs), particularly — early choroidal melanomas. This article analyzes OCT findings in 15 patients whose initial diagnosis of “choroidal hemangioma” was revised to “choroidal melanoma” in 11 cases and to “progressive nevus” in 4 cases. The mean tumor prominence was 2.22±0.82 mm, and the mean diameter was 8.01±2.72 mm. The analysis identified OCT patterns frequently responsible for diagnostic errors, such as cystoid changes and the “subretinal cleft.” Therefore, for accurate diagnosis and to avoid treatment planning errors, OCT findings must be interpreted in conjunction with fundus examination and in the context of patient’s medical history.