Oman Journal of Ophthalmology

CLINICAL IMAGE
Year
: 2016  |  Volume : 9  |  Issue : 3  |  Page : 187--188

Choroidal melanoma masquerading as multifocal central serous chorioretinopathy


Pukhraj Rishi, Ramya Appanraj, Tarun Sharma 
 Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India

Correspondence Address:
Pukhraj Rishi
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, 18 College Road, Chennai 600 006, Tamil Nadu
India

Abstract

A 56 year-old-male presented with diminution of vision in right eye of 2 months duration. His best corrected visual acuity (BCVA) was 20/25. Anterior segment examination was bilaterally normal. Right fundus revealed oval, raised, pigmented lesion in superotemporal quadrant with subfoveal fluid. Fundus fluroscein angiography (FFA) showed multiple pinpoint leakages. Acoustic hollowing on ultrasound (USG) was typical of choroidal melanoma. A high index of suspicion is required for the diagnosis of small choroidal melanoma that could present with multiple focal leaks and subretinal fluid simulating multifocal central serous retinopathy (CSR).



How to cite this article:
Rishi P, Appanraj R, Sharma T. Choroidal melanoma masquerading as multifocal central serous chorioretinopathy .Oman J Ophthalmol 2016;9:187-188


How to cite this URL:
Rishi P, Appanraj R, Sharma T. Choroidal melanoma masquerading as multifocal central serous chorioretinopathy . Oman J Ophthalmol [serial online] 2016 [cited 2019 Jun 27 ];9:187-188
Available from: http://www.ojoonline.org/text.asp?2016/9/3/187/192305


Full Text

A 56-year-old-male presented with diminution of vision in right eye of 2 months duration. His best corrected visual acuity was 20/25. Anterior segment examination was bilaterally normal except for early cataractous changes. Left fundus was normal. Right fundus revealed areas of pigmentary alterations and subfoveal fluid [Figure 1]. Indirect ophthalmoscopy revealed an oval, raised, pigmented lesion in superotemporal quadrant with hyper-autofluorescence extending to the area of subretinal fluid (SRF) [Figure 2]. Fundus fluorescein angiography showed multiple pinpoint leakages [Figure 3], while indocyanine green angiography revealed blocked fluorescence [Figure 4]. Acoustic hollowing on ultrasound (USG) was typical of choroidal melanoma [Figure 5]a. Optical coherence tomography confirmed SRF [Figure 5]b overlying the tumor.{Figure 1}{Figure 2}{Figure 3}{Figure 4}{Figure 5}

A mnemonic for easy diagnosis of small melanoma is "To find small ocular melanoma using helpful hints daily", where T: Thickness >2 mm, F: Subretinal fluid, S: Symptoms, O: Presence of orange pigment, M: Tumor margin within 3 mm of optic disc, H: USG hollowness, H: Halo absence, and D: Drusen absent. [1],[2],[3],[4] Seven of these eight risk factors were present in this case, and diagnosis of small choroidal melanoma was established. Metastatic workup, including USG abdomen, chest X-ray, and liver function test, was normal.

A high index of suspicion is required for the diagnosis of small choroidal melanoma that could present with multiple focal leaks and SRF simulating multifocal central serous retinopathy.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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