Localized suprachoroidal hematomas. Ophthalmoscopic features, fluorescein angiography, and clinical course

We describe the ophthalmoscopic characteristics, fluorescein angiographic features, and clinical course of four patients with a localized suprachoroidal hematoma. Each of the four patients developed a darkly pigmented fundus lesion a short time following uncomplicated intraocular surgery. In every case, the lesion appeared ophthalmoscopically similar to a choroidal malignant melanoma. However, fluorescein angiography showed neither choroidal fluorescence blockage nor the double-circulation pattern characteristic of choroidal melanomas. Instead, each lesion exhibited a central fluorescein pattern similar to that of the surrounding uninvolved choroid, relative marginal hypofluorescence, and overlying choroidal folds. Ultrasonography revealed acoustic hollowness of each lesion without choroidal excavation. The lesions disappeared completely within 1 to 2 months, leaving no visible trace. We discuss the differential diagnosis of these lesions and stress the diagnostic value of fluorescein angiography.