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Uveal melanoma presenting as cataract and staphyloma.

Khetan V, Gupta K, Mohan ER, Gopal L - Indian J Ophthalmol (2009 May-Jun)

Bottom Line: The left eye was blind for six months.The ultrasound of the eye showed a large mass filling the superior, nasal and inferonasal vitreous cavity with high surface reflectivity and low to moderate internal reflectivity.Magnetic resonance imaging (MRI) confirmed the diagnosis of choroidal melanoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Vitreoretina and Ocular Oncology, Medical Research Foundation, Sankara Nethralaya, Chennai, India. drkhetan@yahoo.com

ABSTRACT
Blind eyes can harbor a choroidal melanoma. We report a case of uveal melanoma presenting as staphyloma and complicated cataract in a 45-year-old female. The left eye was blind for six months. She underwent comprehensive ocular examination but fundus examination was precluded due to total cataract. The ultrasound of the eye showed a large mass filling the superior, nasal and inferonasal vitreous cavity with high surface reflectivity and low to moderate internal reflectivity. Magnetic resonance imaging (MRI) confirmed the diagnosis of choroidal melanoma. The patient underwent extended enucleation and histopathology was consistent with uveal melanoma.

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Clinical appearance of the right eye
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Figure 0001: Clinical appearance of the right eye

Mentions: A 45-year-old lady presented to us with a history of painless swelling in the left eye associated with decrease in vision since six months. On ophthalmic examination, she had a best corrected visual acuity (BCVA) of 20/20 in the right eye and light perception with inaccurate projection of rays in the left eye. The anterior segment examination in the right eye was within normal limits. In the left eye there was a staphyloma in the superonasal quadrant, close to the limbus measuring 6 × 6 mm. It was irregular in shape, brown in color with overlying scleral thinning and a sentinel vessel temporal to the staphyloma [Figs. 1a, b]. Iris showed 360° rubeosis and the lens was totally cataractous. The pupil was fixed and dilated. The extraocular motility was restricted on elevation. Applanation tonometry was 36mm of Hg. Gonioscopy revealed 360 degrees closed angles. There was no fundal glow in the left eye. Fundus examination of right eye showed a disc with 0.6 cup-disc ratio, temporal pallor and inferior neuroretinal rim thinning.


Uveal melanoma presenting as cataract and staphyloma.

Khetan V, Gupta K, Mohan ER, Gopal L - Indian J Ophthalmol (2009 May-Jun)

Clinical appearance of the right eye
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2683430&req=5

Figure 0001: Clinical appearance of the right eye
Mentions: A 45-year-old lady presented to us with a history of painless swelling in the left eye associated with decrease in vision since six months. On ophthalmic examination, she had a best corrected visual acuity (BCVA) of 20/20 in the right eye and light perception with inaccurate projection of rays in the left eye. The anterior segment examination in the right eye was within normal limits. In the left eye there was a staphyloma in the superonasal quadrant, close to the limbus measuring 6 × 6 mm. It was irregular in shape, brown in color with overlying scleral thinning and a sentinel vessel temporal to the staphyloma [Figs. 1a, b]. Iris showed 360° rubeosis and the lens was totally cataractous. The pupil was fixed and dilated. The extraocular motility was restricted on elevation. Applanation tonometry was 36mm of Hg. Gonioscopy revealed 360 degrees closed angles. There was no fundal glow in the left eye. Fundus examination of right eye showed a disc with 0.6 cup-disc ratio, temporal pallor and inferior neuroretinal rim thinning.

Bottom Line: The left eye was blind for six months.The ultrasound of the eye showed a large mass filling the superior, nasal and inferonasal vitreous cavity with high surface reflectivity and low to moderate internal reflectivity.Magnetic resonance imaging (MRI) confirmed the diagnosis of choroidal melanoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Vitreoretina and Ocular Oncology, Medical Research Foundation, Sankara Nethralaya, Chennai, India. drkhetan@yahoo.com

ABSTRACT
Blind eyes can harbor a choroidal melanoma. We report a case of uveal melanoma presenting as staphyloma and complicated cataract in a 45-year-old female. The left eye was blind for six months. She underwent comprehensive ocular examination but fundus examination was precluded due to total cataract. The ultrasound of the eye showed a large mass filling the superior, nasal and inferonasal vitreous cavity with high surface reflectivity and low to moderate internal reflectivity. Magnetic resonance imaging (MRI) confirmed the diagnosis of choroidal melanoma. The patient underwent extended enucleation and histopathology was consistent with uveal melanoma.

Show MeSH
Related in: MedlinePlus