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By Michael Seider, MD
The Southern California Permanente Medical Group - Uploaded on Feb 13, 2020.
- Last modified by Caroline Bozell on Feb 14, 2020.
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- Large choroidal melanoma with retinal breakthrough
- Description
- Atypical presentation of a large pigmented choroidal melanoma in an individual of Caucasian descent. The melanoma has an irregular shape and has broken through the retina superior to the macula of the right eye. The lesion partially overlies the optic nerve. The tumor is not associated with the subretinal fluid/exudative retinal detachment often seen with choroidal melanoma because of the primary location within the vitreous chamber. The tumor is very hypo-autofluorescent as no retinal pigment epithelial tissue is overlying it. Some hyper-autofluorescent signal is seen in the macula from previous subretinal fluid. Optical coherence tomography confirms no subretinal fluid in the macula, mild epiretinal membrane, and outer retinal loss nasally from previous subretinal fluid. B-Scan ultrasonography shows moderate internal reflectivity (more common when considering deeply pigmented melanomas when compared to “classic” low internal reflectivity) and tenting of the hyaloid from the tumor (not commonly seen in uveal melanoma as it usually does not project into the vitreous chamber). No retinal detachment is present.