Feb 13 2020 by Yoshihiro Yonekawa, MD

Fluorescein angiography, late frame, of a teenage girl with submacular fluid from a colobomatous optic disc. The camera is focused is on the elevated macula, and the disc is subtly defocused.

Photographer: Netanya Lerner, COA, Wills Eye Hospital/Mid Atlantic Retina

Imaging device: Topcon

Condition/keywords: chorioretinal coloboma, coloboma of optic disc, congenital optic nerve pit, subretinal fluid

Feb 13 2020 by Yoshihiro Yonekawa, MD

Beautifully focused fundus photograph of a teenage girl with submacular fluid from a colobomatous optic disc.

Photographer: Netanya Lerner, COA, Wills Eye Hospital/Mid Atlantic Retina

Imaging device: Topcon

Condition/keywords: chorioretinal coloboma, coloboma of optic disc, congenital optic nerve pit, subretinal fluid

Feb 13 2020 by Michael Seider, MD

Very large choroidal melanoma in the left eye of a 51-year-old man with long-standing poor vision in the right eye from a childhood injury (with traumatic macular hole and chorioretinal scarring). Note the large superior choroidal tumor with overlying subretinal hemorrhage and extensive inferior exudative retinal detachment. B-Scan ultrasound shows the collar-stud shape of the lesion and the overlying subretinal hemorrhage which is hyper-reflective compared to the vitreous and slightly hypo-reflective compared to the tumor. The patient has optic disk drusen in both eyes. He elected enucleation.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

Very large choroidal melanoma in the left eye of a 51-year-old man with long-standing poor vision in the right eye from a childhood injury (with traumatic macular hole and chorioretinal scarring). Note the large superior choroidal tumor with overlying subretinal hemorrhage and extensive inferior exudative retinal detachment. B-Scan ultrasound shows the collar-stud shape of the lesion and the overlying subretinal hemorrhage which is hyper-reflective compared to the vitreous and slightly hypo-reflective compared to the tumor. The patient has optic disk drusen in both eyes. He elected enucleation.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

Very large choroidal melanoma in the left eye of a 51-year-old man with long-standing poor vision in the right eye from a childhood injury (with traumatic macular hole and chorioretinal scarring). Note the large superior choroidal tumor with overlying subretinal hemorrhage and extensive inferior exudative retinal detachment. B-Scan ultrasound shows the collar-stud shape of the lesion and the overlying subretinal hemorrhage which is hyper-reflective compared to the vitreous and slightly hypo-reflective compared to the tumor. The patient has optic disk drusen in both eyes. He elected enucleation.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

Large, irregularly shaped choroidal melanoma with overlying subretinal fluid and inferior exudative retinal detachment in the right eye of a 93-year-old woman. Note the extensive overlying orange pigment (lipofuscin) which is hyper-autofluorescent. B-Scan ultrasonography confirms low tumor internal reflectivity, adjacent retinal detachment and multi-lobulated shape. Especially because of the poor baseline vision and the severe vision loss expected from radiotherapy (because of the larger tumor size and proximity to the optic nerve), this older woman elected primary enucleation.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

Large, irregularly shaped choroidal melanoma with overlying subretinal fluid and inferior exudative retinal detachment in the right eye of a 93-year-old woman. Note the extensive overlying orange pigment (lipofuscin) which is hyper-autofluorescent. B-Scan ultrasonography confirms low tumor internal reflectivity, adjacent retinal detachment and multi-lobulated shape. Especially because of the poor baseline vision and the severe vision loss expected from radiotherapy (because of the larger tumor size and proximity to the optic nerve), this older woman elected primary enucleation.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

Large, irregularly shaped choroidal melanoma with overlying subretinal fluid and inferior exudative retinal detachment in the right eye of a 93-year-old woman. Note the extensive overlying orange pigment (lipofuscin) which is hyper-autofluorescent. B-Scan ultrasonography confirms low tumor internal reflectivity, adjacent retinal detachment and multi-lobulated shape. Especially because of the poor baseline vision and the severe vision loss expected from radiotherapy (because of the larger tumor size and proximity to the optic nerve), this older woman elected primary enucleation.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

Large, irregularly shaped choroidal melanoma with overlying subretinal fluid and inferior exudative retinal detachment in the right eye of a 93-year-old woman. Note the extensive overlying orange pigment (lipofuscin) which is hyper-autofluorescent. B-Scan ultrasonography confirms low tumor internal reflectivity, adjacent retinal detachment and multi-lobulated shape. Especially because of the poor baseline vision and the severe vision loss expected from radiotherapy (because of the larger tumor size and proximity to the optic nerve), this older woman elected primary enucleation.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

Large, dome-shaped peripheral choroidal melanoma of the left eye with inferior exudative retinal detachment. Note the lack of obvious orange pigment over the tumor and apparent drusen anteriorly. A lack of ophthalmoscopically obvious lipofuscin is not uncommon among larger choroidal melanomas. B-Scan ultrasonography (transverse, 10 o’clock) confirms a low-moderate internally reflective dome-shaped choroidal lesion with a small adjacent retinal detachment. Ultrasound biomicroscopy (radial, 10 o’clock) confirms no ciliary body involvement of the tumor.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

Large, dome-shaped peripheral choroidal melanoma of the left eye with inferior exudative retinal detachment. Note the lack of obvious orange pigment over the tumor and apparent drusen anteriorly. A lack of ophthalmoscopically obvious lipofuscin is not uncommon among larger choroidal melanomas. B-Scan ultrasonography (transverse, 10 o’clock) confirms a low-moderate internally reflective dome-shaped choroidal lesion with a small adjacent retinal detachment. Ultrasound biomicroscopy (radial, 10 o’clock) confirms no ciliary body involvement of the tumor.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

Large, dome-shaped peripheral choroidal melanoma of the left eye with inferior exudative retinal detachment. Note the lack of obvious orange pigment over the tumor and apparent drusen anteriorly. A lack of ophthalmoscopically obvious lipofuscin is not uncommon among larger choroidal melanomas. B-Scan ultrasonography (transverse, 10 o’clock) confirms a low-moderate internally reflective dome-shaped choroidal lesion with a small adjacent retinal detachment. Ultrasound biomicroscopy (radial, 10 o’clock) confirms no ciliary body involvement of the tumor.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

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.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

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.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

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.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

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.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

Small, peripapillary choroidal melanoma of the left eye. Note the diffuse borders, clumped overlying orange pigment (lipofuscin) and lack of drusen. The standard fundus photograph reveals the true color of the lesion. The wide-field Optos photograph shows the lesion as being more green than the true color, although the lipofuscin remains prominently orange. Wide-field fundus autofluoresence shows a bright signal corresponding to the orange pigment and also superior and inferior to the optic nerve, likely from previous exposure to subretinal fluid. Optical coherence tomography confirms the subretinal fluid seen on examination. B-Scan ultrasonography shows a very low-lying choroidal lesion adjacent to the optic nerve.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

Small, peripapillary choroidal melanoma of the left eye. Note the diffuse borders, clumped overlying orange pigment (lipofuscin) and lack of drusen. The standard fundus photograph reveals the true color of the lesion. The wide-field Optos photograph shows the lesion as being more green than the true color, although the lipofuscin remains prominently orange. Wide-field fundus autofluoresence shows a bright signal corresponding to the orange pigment and also superior and inferior to the optic nerve, likely from previous exposure to subretinal fluid. Optical coherence tomography confirms the subretinal fluid seen on examination. B-Scan ultrasonography shows a very low-lying choroidal lesion adjacent to the optic nerve.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

Small, peripapillary choroidal melanoma of the left eye. Note the diffuse borders, clumped overlying orange pigment (lipofuscin) and lack of drusen. The standard fundus photograph reveals the true color of the lesion. The wide-field Optos photograph shows the lesion as being more green than the true color, although the lipofuscin remains prominently orange. Wide-field fundus autofluoresence shows a bright signal corresponding to the orange pigment and also superior and inferior to the optic nerve, likely from previous exposure to subretinal fluid. Optical coherence tomography confirms the subretinal fluid seen on examination. B-Scan ultrasonography shows a very low-lying choroidal lesion adjacent to the optic nerve.

Condition/keywords: choroidal melanoma

Feb 13 2020 by Michael Seider, MD

Small, peripapillary choroidal melanoma of the left eye. Note the diffuse borders, clumped overlying orange pigment (lipofuscin) and lack of drusen. The standard fundus photograph reveals the true color of the lesion. The wide-field Optos photograph shows the lesion as being more green than the true color, although the lipofuscin remains prominently orange. Wide-field fundus autofluoresence shows a bright signal corresponding to the orange pigment and also superior and inferior to the optic nerve, likely from previous exposure to subretinal fluid. Optical coherence tomography confirms the subretinal fluid seen on examination. B-Scan ultrasonography shows a very low-lying choroidal lesion adjacent to the optic nerve.

Condition/keywords: choroidal melanoma