Amelanotic retinal melanoma

Case contributed by Dinesh Brand
Diagnosis almost certain

Presentation

Monitoring amelanotic retinal melanoma near the right macula for photodynamic therapy.

Patient Data

Age: 50 years
Gender: Female
ultrasound

The anterior chamber of the eye appears unremarkable. The lens is anechoic and is lying in the correct position. There is no evidence of a retinal or choroidal detachment. There is a small amount of debris visible with in the vitreous chamber. The optic disk appears unremarkable.

The choroidal lesion noted in the temporal aspect of the globe measures 2.0mm in AP dimension in this examination. The transverse base measurement was 13.0mm, longitudinal base measurement at 10.0mm. There is mild increased vascularity of the lesion.

Case Discussion

Previous ultrasound of the right eye two months prior showed a choroidal mass depth of 4.1mm (prior to this was a measurement of 3.5mm), transverse base measurement of 11.7mm and longitudinal base measurement was 11.0mm. 

In all ultrasound examinations, both the right and left eye was examined. 

Campbell and Pejnovic in 2012 concluded that photodynamic therapy was highly effective in causing regression of posteriorly located amelanotic choroidal melanomas, without a detrimental effect on vision. While the short-term results are encouraging, however, there is some uncertainty regarding complete tumor destruction and long-term efficacy.

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