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Hemorrhagic retinal macrocysts, simulating choroidal melanoma: a case report
Ahmad M Mansour1, Mahmoud O Jaroudi
1Department of Ophthalmology, American University of Beirut, Beirut, Lebanon.
Clinical Ophthalmology (Auckland, N.Z.)
|June 14, 2013
Summary
Hemorrhagic retinal macrocysts are rare and can mimic choroidal melanoma, potentially leading to misdiagnosis. Early identification through characteristic features can prevent unnecessary treatments like brachytherapy.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Medical Imaging
Background:
- Hemorrhagic retinal macrocysts are exceptionally rare retinal lesions.
- These lesions can be misdiagnosed as malignant tumors, such as choroidal melanoma.
- Misdiagnosis can lead to aggressive, unnecessary treatments like enucleation or brachytherapy.
Observation:
- A 15-year-old boy presented with sudden visual loss and vitreous hemorrhage in his left eye.
- Magnetic resonance imaging (MRI) showed a mass with specific signal characteristics (T1 hyperintense, T2 isointense, no enhancement).
- The patient underwent a scleral buckle procedure.
Findings:
- The hemorrhagic retinal macrocyst gradually collapsed post-surgery over 5 weeks.
- The patient achieved significant visual recovery, with acuity of 6/7.5 at 1-year follow-up.
- Key diagnostic features include an egg shape, specific cyst wall configuration, lack of choroidal attachment, and presence of retinal detachment.
Implications:
- Accurate diagnosis of hemorrhagic retinal macrocysts is crucial to avoid misdiagnosis as choroidal melanoma.
- Recognizing specific imaging and clinical features aids in differentiating macrocysts from malignancy.
- Prompt and correct diagnosis can prevent sight-threatening interventions and ensure appropriate management.
