1/9. Blackening of a choroidal hemangioma after photodynamic therapy.BACKGROUND: Photodynamic therapy has recently advanced to a first line treatment of symptomatic circumscribed choroidal hemangiomas. history AND SIGNS: A sixty-year-old male patient was referred with progressive visual loss in his left eye. visual acuity measured 20/80 and fundus examination revealed a prominent red subretinal lesion superior to the fovea with adjacent pigment epithelial irregularities. Thickening of the central retina was seen on OCT imaging. Sonography revealed a dome-shaped lesion with a maximal thickness of 3.3 mm and high internal reflectivity. Combined fundus indocyanine green and fluorescein angiography showed early filling of large vessels within the tumor. THERAPY AND OUTCOME: The hemangioma was treated with verteporphin photodynamic therapy. Two days after treatment, with vision unchanged, fundus examination revealed blackening of the tumor. Two months later vision increased to 20/40 and the tumor area was atrophic and bright red with a slight hyperpigmented rim. Angiography revealed the disappearance of tumor vessels and choroidal hypoperfusion in the area of treatment. CONCLUSIONS: Choroidal hemangiomas may darken initially after photodynamic therapy. This is most probably caused by large coaguli within the voluminous lacuna-like blood-filled vessel system of the hemangioma that are induced by photothrombosis.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
2/9. Choroidal melanoma with massive extrascleral extension in a young black man.The reported incidence of choroidal melanoma is low among the general population and is especially low among blacks. Choroidal melanoma is seen most commonly in whites in the sixth to seventh decades. The tumor is complicated by orbital invasion in only a small percentage of cases. This report describes the case of a 38-year-old black man diagnosed with a choroidal melanoma of the right eye. The tumor exhibited extensive orbital invasion. Primary or metastatic disease elsewhere in the body was ruled out, and the patient underwent an eyelid-sparing orbital exenteration. Histopathologic examination of the orbital specimen confirmed the diagnosis of spindle cell-type choroidal melanoma. Orbital invasion by a primary choroidal melanoma in a black person under the age of 40 is highly unusual. To our knowledge, this represents the youngest reported case of choroidal melanoma with extrascleral extension in a black patient. Ophthalmologists should consider the possibility of this potentially deadly tumor, even in young, black patients.- - - - - - - - - - ranking = 9keywords = black (Clic here for more details about this article) |
3/9. Choroidal melanoma with pigment dispersion in vitreous and melanomalytic glaucoma.A 39-year-old black man underwent enucleation of the left eye because of poor vision, ocular pain, and intractable glaucoma secondary to a choroidal tumor. Two diagnostic vitrectomies, performed 11 and 7 months before enucleation, had failed to disclose the proper diagnosis. Histologic diagnosis was necrotic malignant melanoma of the choroid with melanocytoma cells, extensive pigment dispersion throughout the eye, and melanomalytic glaucoma. Possible mechanisms of tumor necrosis are reviewed.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
4/9. Multiple choroidal osteomas developing in association with recurrent orbital inflammatory pseudotumor.Multiple choroidal osteomas developed in a 10-year-old black girl during recurrent episodes of bilateral orbital inflammatory pseudotumor, mild endophthalmitis, and a transient period of mild secondary hyperparathyroidism. The preponderance of these tumors in girls and women suggests that sex hormones may play a role in their pathogenesis; in our case, inflammation also seems to have been an important factor.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
5/9. Choroidal granuloma in sarcoidosis.We examined two patients--a 33-year-old black man and a 62-year-old white woman--who had pale yellow choroidal tumefactions with subretinal fluid and reduced vision. One patient had a history of granulomatous iritis; both patients were initially thought to have metastatic choroidal carcinoma. Systemic investigation yielded positive tissue diagnosis for sarcoidosis, leading to the diagnosis of presumed sarcoid choroidal infiltration. There was striking absence of inflammation of the retina, retinal vessels, and vitreous cavities. fluorescein angiography disclosed initial hypofluorescence and late hyperfluorescence and ultrasonography demonstrated medium internal reflectivity. Neither study could exclude metastatic choroidal carcinoma. One patient had an increased level of angiotensin-converting enzyme on serial determinations through 15 months of observation and during treatment with corticosteroids, indicating a good correlation with improved vision and flattening of the choroidal granuloma. In both cases there was only partial resolution of the choroidal granuloma with corticosteroids. We conclude that choroidal granuloma can be the sole ocular manifestation of sarcoidosis and in this context is likely to be confused with metastatic choroidal carcinoma. We also believe that biopsy confirmation is needed because noninvasive tests such as gallium scans and angiotensin-converting enzyme cannot be relied on for diagnosing sarcoidosis and excluding carcinoma.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
6/9. Resection of uveal melanocytoma: clinicopathological correlation.Four patients had pigmented lesions in the anterior uveal tract and choroid which presented clinically as malignant melanomas. All the lesions were successfully removed by local excision. Histopathological studies showed the tumours to be melanocytomas, indicating that enucleation or irradiation would have been contraindicated. The 3 patients with iris and ciliary body melanocytomas continue to maintain corrected visual acuities of 20/30 or better. In the patient with choroidal melanocytoma central visual acuity was compromised owing to cystoid macular oedema. All 3 melanocytomas involving the anterior segment were located inferiorly. Biomicroscopically, they were chocolate coloured (not black) and resembled malignant melanomas of the same location. The choroidal melanocytoma also resembled a malignant melanoma by ophthalmoscopic and angiographic criteria, and did not have the jet black or homogeneous pigmentation that characterises most melanocytomas of the disc.- - - - - - - - - - ranking = 2keywords = black (Clic here for more details about this article) |
7/9. Bilateral choroidal osteomas associated with fatal systemic illness.An 11-year-old black boy complained of intermittent occipital headaches with nausea and projectile vomiting. Previous skin and lung biopsy specimens were interpreted as histiocytosis X. Cranial computed tomographic scanning disclosed a mass lesion in the region of the choroid plexus of the left lateral ventricle. This was surgically removed but proved nondiagnostic despite extensive histologic examination. An ophthalmologic evaluation showed discrete, elevated, yellow-white choroidal tumors in both maculas. The ophthalmoscopic appearance, as well as ultrasonography and computed tomography, led to the diagnosis of choroidal osteomas.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
8/9. Malignant melanoma of the choroid in the nevus of ota of a black patient.To our knowledge, this report is the first description of an association of a choroidal melanoma in the nevus of ota in a black patient. While white patients who have the nevus of ota appear to be predisposed to the development of a malignant melanoma, this complication is rare in all nonwhite racial groups. Nevertheless, it should be realized that regardless of the patient's race, there is a greater than normal chance that a patient with the nevus of ota might have a malignant melanoma develop within one of the affected tissues.- - - - - - - - - - ranking = 5keywords = black (Clic here for more details about this article) |
9/9. Choroidal osteoma in a 6-year-old child.A healthy 6-year-old black girl presented with an asymptomatic lesion in the posterior pole of the left eye. The lesion had the classic clinical features on ophthalmoscopy and ultrasonography of a choroidal osteoma. It is important that other benign and malignant processes such as malignant melanoma, metastatic tumor, and choroidal hemangioma can simulate this benign tumor. A good clinical history and examination followed by carefully selected ancillary tests such as ultrasonography should confirm the diagnosis of choroidal osteoma. To our knowledge this case is the youngest reported case and the first black patient reported.- - - - - - - - - - ranking = 2keywords = black (Clic here for more details about this article) |