1/15. Malignant melanoma arising in a choroidal magnacellular nevus (melanocytoma).A case is presented of a 55-year-old Caucasian male whose right eye was enucleated for a mixed spindle-A and spindle-B malignant melanoma in 1967. The ophthalmoscopic picture, fluorescein angiography, and overlying peculiar orange pigmentation were suggestive of a malignant lesion. Study of serial sections of the entire lesion made possible the histologic reconstruction of the lesion, clinicopathologic correlation of the yellow-orange pigment, and the location of the nevus and mixed spindle-cell melanoma components.- - - - - - - - - - ranking = 1keywords = orange (Clic here for more details about this article) |
2/15. Extramedullary plasmacytoma confined to the choroid.PURPOSE: To report a case of an extramedullary plasmacytoma confined to the choroid. methods: Interventional case report with cytopathologic correlation. RESULTS: A 76-year-old asymptomatic woman presented with 2 globular orange and amelanotic choroidal lesions in the right eye. Fine needle aspiration biopsy of one of the choroidal lesions followed by immunocytochemical studies revealed monoclonal plasma cells, diagnostic of plasmacytoma. Systemic evaluation was negative, except for increased serum gamma globulin with immunoglobulin kappa spike on electrophoresis. The patient was managed by ocular external beam radiotherapy. At 9 years follow-up, she was free of local disease and never developed multiple myeloma. CONCLUSION: Extramedullary plasmacytoma confined to the choroid is rare. It may present simulating other common amelanotic choroidal lesions. Fine needle aspiration biopsy and proper systemic evaluation are critical in establishing the diagnosis.- - - - - - - - - - ranking = 0.5keywords = orange (Clic here for more details about this article) |
3/15. Pseudohypopyon of orange pigment overlying a stable choroidal nevus.PURPOSE: To report an unusual case of orange pigment pseudohypopyon overlying a choroidal nevus. methods: Observational case report. A 45-year-old man presented with best-corrected visual acuity of 20/25 and metamorphopsia in the right eye secondary to localized subfoveal fluid. The detachment displayed a peculiar appearance of layered orange pigment, like a pseudohypopyon in its inferior aspect. Closer inspection revealed an underlying choroidal nevus and no choroidal neovascular membrane. RESULTS: After 31 months of follow-up without treatment, the size of the nevus and visual acuity remained stable and metamorphopsia continued to resolve as the orange pigment and the subretinal fluid disappeared completely. CONCLUSION: An otherwise stable choroidal nevus can display overlying clumps of orange pigment and rarely massive accumulation of orange pigment in the form of a pseudohypopyon. Orange pigment pseudohypopyon can spontaneously resolve with preserved visual acuity.- - - - - - - - - - ranking = 4.5keywords = orange (Clic here for more details about this article) |
4/15. Optical coherence tomography of choroidal osteoma.PURPOSE: To examine the cross-sectional structure of a choroidal osteoma using optical coherence tomography. methods: Observational case report. A choroidal osteoma in the right eye of a 22-year-old woman was studied with fluorescein and indocyanine green fundus angiograms and optical coherence tomography. RESULTS: The optical coherence tomography showed that a creamy-white lesion in the tumor had an increased reflectivity with a cavernous structure, whereas an orange lesion showed less reflectivity beneath the apparently intact retinal pigment epithelium. The area of less-intense whiteness in the creamy-white lesion showed higher reflectivity at the level of the retinal pigment epithelium, which precluded our viewing the deeper structure of the tumor. CONCLUSION: Optical coherence tomography can demonstrate the cavernous structure of a choroidal osteoma at a selective stage of a tumor's evolution, namely, when the retinal pigment epithelium is atrophied and the ossification is premature.- - - - - - - - - - ranking = 0.5keywords = orange (Clic here for more details about this article) |
5/15. Clinicopathological correlation of polypoidal choroidal vasculopathy revealed by ultrastructural study.AIMS: To describe the clinical and histopathological findings in a patient with polypoidal choroidal vasculopathy. methods: A 76 year old Japanese man had a discrete, orange-red lesion of 1 disc diameter in the macula, with the fluorescein and indocyanine green angiographic and optical coherence tomographic findings compatible with polypoidal choroidal vasculopathy. He underwent a surgical removal of the macular lesion, followed by light and electron microscopic examinations. RESULTS: The histopathological examination revealed that the specimen consisted of degenerated retinal pigment epithelium-Bruch's membrane-choriocapillaris complex and inner choroid. A tortuous, unusually dilated venule was present adjacent to an arteriole with marked sclerotic changes, appearing to form arteriovenous crossing. These vessels seemed to represent native inner choroidal vessels, and had haemorrhage per diapedesis. blood cells and fibrin filled the lumina of the vessels and accumulated in the extravascular spaces, indicating vascular stasis. CONCLUSION: Hyperpermeability and haemorrhage due to stasis of a dilated venule and an arteriole involved by sclerosis at the site where they cross in the inner choroid might cause oedema and degeneration of the tissue. Voluminous accumulation of blood cells and fibrin might generate elevation of tissue pressure sufficient to displace the weakened lesion anteriorly. The result suggests that the polypoidal vessels in this case represent abnormality in the inner choroidal vasculature.- - - - - - - - - - ranking = 0.5keywords = orange (Clic here for more details about this article) |
6/15. Papillary carcinoma thyroid presenting as a choroidal metastasis. Report of a case and brief review of literature.A patient of papillary thyroid carcinoma, who initially presented with a choroidal metastasis and secondary intractable glaucoma is reported. The orange-coloured tumour posed a diagnostic difficulty, until histopathology of the enucleated eye confirmed the metastasis from the thyroid. The initial presentation of distant metastasis in patients with thyroid cancer is rare.- - - - - - - - - - ranking = 0.5keywords = orange (Clic here for more details about this article) |
7/15. Rieger anomaly with bilateral choroidal osteoma: coincidence or association?PURPOSE: To report a case of Rieger anomaly associated with bilateral choroidal osteoma. CASE: An 18-year-old woman presented with corectopia, iridocorneal adhesions, and stromal hypoplasia of the iris, and was diagnosed with Rieger anomaly. RESULTS: Fundus examination revealed bilateral yellowish-orange, placoid degenerative fundus lesions with pseudopod-like edges associated with the areas of retinal pigment epithelium atrophy, indicating choroidal osteoma. Fundus fluorescein angiography showed bilateral early patchy and late diffuse hyperfluorescence. B-scan echography revealed placoid lesion at the posterior ocular coats characterized by localized areas of high ultrasound reflectivity with a corresponding retrobulbar orbital shadowing. This indicated a dense calcium foreign body. In addition, computed tomography of the orbit demonstrated bilateral plate-like thickening with calcification of the choroid that was isodense with the normal skeletal bone. CONCLUSIONS: Although Rieger anomaly is classically known as a disease of the anterior segment of the eye, choroidal osteoma may be a posterior segment finding of the disease that has not previously been reported.- - - - - - - - - - ranking = 0.5keywords = orange (Clic here for more details about this article) |
8/15. iodine-125 plaque radiotherapy of choroidal hemangioma.BACKGROUND: Circumscribed choroidal hemangioma (CCH) is a benign vascular tumor that is not associated with systemic abnormalities and its pathogenesis is unknown. Most choroidal hemangiomas remain stable in size, and treatment is periodic observation unless complicated by an overlying serous retinal detachment. CASE REPORT: A 43-year-old white man came to our clinic reporting decreased vision in the left eye for 1 year. On funduscopic evaluation, a large elevated nonpigmented red-orange lesion, just temporal to the fovea of the left eye, was observed with surrounding areas of subretinal fluid. On the basis of findings obtained through ophthalmoscopy, fluorescein angiography, and ultrasonography, the patient was diagnosed with a circumscribed choroidal hemangioma. Treatment of the CCH was with iodine-125 plaque radiotherapy, which significantly reduced the tumor size and improved vision. CONCLUSION: CCH is a benign vascular tumor that is characteristically nonprogressive, but in cases of vision loss caused by serous detachment of the fovea, argon laser photocoagulation or radiotherapy is the treatment of choice. Recent studies indicate that iodine-125 plaque radiotherapy is indicated for large choroidal hemangiomas involving the macula or with associated retinal detachment. The main goal of treating CCH is to preserve vision and to prevent the progression of vision loss.- - - - - - - - - - ranking = 0.5keywords = orange (Clic here for more details about this article) |
9/15. Circumscribed choroidal hemangioma in a Chinese patient treated using transpupillary thermotherapy: a case report.We describe the first case of a Chinese patient with circumscribed choroidal hemangioma (CCH) effectively managed using transpupillary thermotherapy (TTT). A 57-year-old man had an elevated orange-red subretinal mass with a base of 5 x 5 mm superior to the optic disc, along with serous macular detachment in the left eye. ultrasonography depicted a mass 3 mm thick with acoustic solidity and high internal reflectivity. fluorescein angiography showed an area of hyperfluorescence in the prearterial phase and tumor staining in the late phase, consistent with a diagnosis of CCH. Therefore, TTT (spot size, 3 mm; exposure, 1 min) was performed with a diode laser, delivered through a slit-lamp biomicroscope. The laser power was first set at 300 mW and then increased in 50-mW increments, until test shots in the mid-peripheral retina outside the lesion produced a slightly grayish appearance in the irradiated area. The tumor was covered with four overlapping laser spots and subjected to an average beam power of 400 mW. Best-corrected visual acuity increased from 20/50 before treatment, to 20/20 3 months following one session of TTT. The lesion became atrophic and the subretinal fluid disappeared. Our experience shows that TTT can be an even more effective treatment strategy for CCH in Asians than in Caucasians. In Chinese patients, the power level of the diode laser should be lower than that used in Caucasians.- - - - - - - - - - ranking = 0.5keywords = orange (Clic here for more details about this article) |
10/15. Circumscribed choroidal hemangioma: A case report and review of the literature.BACKGROUND: Choroidal hemangioma is a rare, benign vascular ocular tumor that presents as either a circumscribed mass or as a diffuse variant. Circumscribed choroidal hemangiomas (CCH) resemble posterior segment lesions such as choroidal melanoma, choroidal metastases, central serous chorioretinopathy, or nonspecific retinal detachment. A circumscribed choroidal hemangioma often appears as a subtle red-orange mass or as a grayish lesion in the posterior choroid. In rare instances, CCH may be associated with subretinal fluid accumulation and retinal detachment. CASE REPORT: A 35-year-old Hispanic man presented for a routine eye examination and was observed to have a choroidal lesion in the posterior pole. The lesion is an elevated subretinal mass located superotemporal to the fovea in the right eye. A Humphery visual field 24-2 test found a scotoma corresponding to the location of the lesion. B-scan ultrasound confirmed a fairly dense and large lesion. A-scan showed low to medium internal reflectivity and an acoustically solid lesion. Because the patient was asymptomatic, management through observation was recommended. CONCLUSIONS: Circumscribed choroidal hemangiomas must be adequately differentiated from other vascular tumors. A selective battery of diagnostic tests will facilitate the correct diagnosis. Management of CCH may depend on the character of the lesion and risks of ocular morbidity and vision loss.- - - - - - - - - - ranking = 0.5keywords = orange (Clic here for more details about this article) |
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