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Visual Loss from Choroidal Melanoma Mimicking Neurological Syndromes

Hammamji, K; Reich, E; Arora, A; Cohen, VML; Sagoo, MS; (2017) Visual Loss from Choroidal Melanoma Mimicking Neurological Syndromes. Case Reports in Neurology , 9 (1) pp. 31-35. 10.1159/000462970. Green open access

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Abstract

Melanoma of the eye is rare, but can mimic a range of disorders. This report highlights 2 cases of choroidal melanoma with vision loss mimicking neurological diagnoses. The first patient is a 41-year-old white male with a known history of multiple sclerosis and a previous episode of optic neuritis in the right eye, who presented with a 6-month history of decreased vision in the same eye, and occasional photopsiae. He was treated with 2 courses of oral steroids for presumed recurrent optic neuritis. After a temporary improvement in his symptoms, his vision worsened, following which he had a head MRI, which revealed a solid intraocular mass. He was subsequently diagnosed with a choroidal melanoma for which he was treated successfully with ruthenium-106 plaque brachytherapy. The second patient is a 57-year-old female, who presented with a progressive cerebellar syndrome under investigation by the neurology service, as well as decreased vision in the right eye. Her visual acuity gradually deteriorated and her neurological assessment, which included a PET-CT, revealed uptake in the right eye. The diagnosis of a choroidal melanoma was made, and following conservative treatment with proton beam radiotherapy, she had an enucleation of the eye. Intraocular tumours can masquerade as many different entities. Unexplained unilateral visual loss, especially if it is atypical for a neurological syndrome, should prompt dilated fundoscopy and referral to an ophthalmologist.

Type: Article
Title: Visual Loss from Choroidal Melanoma Mimicking Neurological Syndromes
Open access status: An open access version is available from UCL Discovery
DOI: 10.1159/000462970
Publisher version: https://doi.org/10.1159/000462970
Language: English
Additional information: Copyright © 2017 The Author(s). Published by S. Karger AG, Basel. This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.
Keywords: Melanoma, Choroid, Masquerade
UCL classification: UCL > School of Life and Medical Sciences
UCL > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology > Institute of Ophthalmology - Ocular Biology
URI: http://discovery.ucl.ac.uk/id/eprint/1549820
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