Choroidal Melanoma Masquerading as Central Serous Chorioretinopathy
Guy S Negretti1, Nicholas E Kalafatis1, Jerry A Shields1
1Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
Ophthalmology. Retina
|August 16, 2022
Summary
Choroidal melanoma can mimic central serous chorioretinopathy (CSCR). Multimodal imaging is crucial for differentiating these conditions, as delayed diagnosis of melanoma can lead to vision loss and metastasis.
Area of Science:
- Ophthalmology
- Oncology
Background:
- Central serous chorioretinopathy (CSCR) is a common condition affecting the macula.
- Choroidal melanoma can present with similar symptoms, leading to misdiagnosis.
Purpose of the Study:
- To identify clinical features and outcomes of choroidal melanoma initially misdiagnosed as CSCR.
- To improve diagnostic accuracy and patient outcomes.
Main Methods:
- Retrospective case series of 22 patients with choroidal melanoma misdiagnosed as CSCR.
- Analysis of clinical characteristics, ultrasonography, OCT, and various angiography techniques.
- Statistical analysis using paired t tests and chi-squared tests.
Main Results:
- The mean interval between CSCR diagnosis and melanoma suspicion was 50 months.
- Key differentiating features included choroidal thickness asymmetry, surface irregularity, loss of vascular detail on OCT, pinpoint leaks on angiography, and autofluorescence abnormalities.
- Outcomes included vision loss (47%), metastasis (14%), and death (5%).
Conclusions:
- Patients with presumed CSCR, particularly chronic cases, require thorough evaluation for underlying choroidal melanoma.
- Multimodal imaging is essential for distinguishing between CSCR and choroidal melanoma.
