Presentation
Bilateral microphthalmia with decreased visual acuity.
Patient Data
Age: 60 years
Gender: Female
From the case:
Choroidal melanoma
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Info
![](https://prod-images-static.radiopaedia.org/images/54974404/2_big_gallery.jpeg)
The ultrasound demonstrates:
- small echogenic focus within the surface of the optic nerve head bilaterally with posterior acoustic shadowing in keeping with optic disc drusen
- small echogenic intraocular mass with internal vascularity
From the case:
Choroidal melanoma
![](https://prod-images-static.radiopaedia.org/images/54967176/IM0013_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/54967199/IM0012_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/54967140/IM0001_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/54974190/IM0012_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/54974279/IM0006_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/54974287/IM0002_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/54974308/IM0007_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/54976874/IM0006_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/54974343/IM0002_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/54974390/IM0009_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/54974369/IM0013_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/54974238/IM0013_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/54974262/IM0013_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
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Info
![](https://prod-images-static.radiopaedia.org/images/54967176/IM0013_big_gallery.jpeg)
The MRI sequences demonstrate:
- bilateral microphthalmia
- optochiasmatic atrophy
- small right intraocular soft tissue mass at the inferonasal quadrant measuring (7 x 5 x 4 mm) of high signal on T1, low signal on T2 with vivid homogeneous enhancement on postcontrast sequences. No extraocular extension is seen.
- smooth scleral thickening with enhancement choroidal/retinal enhancement
Small vessel chronic ischemic changes are noted.
Case Discussion
MRI features are suggestive of choroidal melanoma in a patient with bilateral microphthalmia with optochiasmatic atrophy. The optic disc drusen was probably an incidental finding.