A 65-year-old woman was referred with a 6-week history of blurry vision, ocular pain, and subconjunctival yellow discoloration in the left eye. Suspicious retinal detachment and intraocular mass were identified, which raised concerns for choroidal melanoma. No symptoms or signs were reported in the right eye. Her ocular history included bilateral cataract surgery 5 years prior. Review of systems yielded negative results, including for ocular trauma, jaundice, and cutaneous melanoma. She had no history of tobacco use.
Please finish quiz first before checking answer.
Read the answer below and download your certificate.
Read the discussion below and retake the quiz.
On examination of the left eye, visual acuity was hand motion, and intraocular pressure was 8 mm Hg. The anterior segment showed diffuse conjunctival chemosis of yellow hue, low-grade aqueous reaction, and pseudophakia (Figure 1A). On the fundus evaluation, large pockets of subretinal fluid suggested choroidal effusion based on marked fluid shifting with head position. B-scan ultrasonography confirmed 4-quadrant choroidal hemorrhage and partially mobile serous retinal detachment. B-scans also exhibited a solid lesion from the 6- to 10-o’clock meridians with irregular shape and variable internal reflectivity, measuring 5.8 mm in height. Magnetic resonance imaging was requested to delineate the mass from the surrounding clot (Figure 1B). In the interim, she received oral steroids aiming to contain the abundant exudation and topical atropine for pain, evolving with minimal clinical improvement on these features.
Sign in to take quiz and track your certificates
JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 Credit(s)™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC
CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Leonardo Lando, MD, Ocular Oncology Service, Department of Ophthalmology and Visual Sciences, Princess Margaret Cancer Centre/University Health Network, 610 University Ave, Toronto, ON M5G 2M9, Canada (email@example.com).
Published Online: March 17, 2022. doi:10.1001/jamaophthalmol.2021.5683
Conflict of Interest Disclosures: Dr Lando reported grants from Pan-American Association of Ophthalmology Sear Scholarship 2019. No other disclosures were reported.
Additional Contributions: We thank the patient for granting permission to publish this information. We thank Daniel Weisbrod, MD, Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ontario, Canada, for his contribution to the article’s written composition. Dr Weisbrod was not compensated for his contribution.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
You currently have no searches saved.
You currently have no courses saved.