First Author: A.González Gómez SPAIN
Co Author(s): A. Garcia Ben A. Soler Garcia M. Lopez Egea Bueno
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Choroidal tumours are relatively uncommon, but it is very important to make a correct diagnosis promptly.
HCU Virgen de la Victoria. Malaga
A 67-year-old woman who reported decreased visual acuity (VA) for a month in her left eye (LE), with no other symptoms of interest. VA in his right eye (RE) was 0.7; and 0.2 in her LE. There were no alterations in biomicroscopy or intraocular pressure. There was an elevated and non-pigmented image of about 6 papillary diameters in the upper hemiretina LE, and choroidal folds in macular area. The peripheral retina was applied. There were no haemorrhages, no lipofuscin, no vascular dilatation. The other eye was normal. Additional tests were requested.
Magnetic resonante (MRI) showed an apparently choroidal tumour that infiltrated sclera and suggested infiltration of the superior rectus muscle, which would be compatible with a melanoma, which presented differential diagnosis with metastasis or haemangioma. The sonographer reported an elevated hypoechogenic lesion compatible with haemangioma. Fluorescein angiography did not provide us much information, only numerous and marked choroidal folds were evident, with no other alterations of interest in vascularization or parenchyma. Indocyanine green (ICG) did not find alterations to clarify the diagnosis. VA was maintained over the time. Analytical and sistemic imaging tests were normal, so there was no related systemic disease. The size of the lesion was slowly declining.
The most frequent intraocular tumour in adults is choroidal melanoma, so it is the first disease to be discarded. We could not establish a definitive diagnosis. There was no associated systemic disease, so metastasis would be less likely. ICG did not show choroidal alteration, so we requested a new MRI to assess the possible muscular, scleral or orbital origin, and possible compressive cause.