# Choroidal melanoma found incidentally in an amblyopic eye

## TL;DR

A 37-year-old patient with a history of amblyopia was found to have choroidal melanoma in the affected eye during a routine diabetic retinopathy screening.

## Contribution

This case highlights the incidental detection of choroidal melanoma in an amblyopic eye during a diabetic retinopathy screening.

## Key findings

- Fundus examination revealed a large achromatic mass in the temporal retina with serous retinal detachment.
- Ocular ultrasound and MRI confirmed a hyperechoic choroidal process, leading to a suspected diagnosis of choroidal melanoma.
- The patient underwent enucleation and was referred for oncology management after pathological confirmation.

## Abstract

We report the case of a 37-year-old patient with profound amblyopia of the left eye from childhood, who attended a consultation as part of diabetic retinopathy screening following a recent diagnosis of diabetes. Ophthalmological examination revealed a visual acuity of 10/10 in the right eye and 1/10 in the left eye. The anterior segment was normal. Fundus examination of the left eye showed a large achromatic mass in the temporal retina, surrounded by a serous retinal detachment with interpapillomacular folds (A). Ocular ultrasound revealed a hyperechoic mushroom-shaped choroidal process with vascularity on colour Doppler ultrasound (B). Orbital Magnetic Resonance Imaging (MRI) revealed left circumscribed intra-orbital process, with mean signal intensity after gadolinium injection (C). After a multidisciplinary meeting, the diagnosis of choroidal melanoma was strongly suspected. Assessment of extent including brain MRI, thoraco-abdominopelvic Computed Tomography (CT) scan and abdominal ultrasound was normal. Given the size of the mass, conservative treatment was not possible. The patient underwent an enucleation and was referred to the oncology department for further management, after anatomopathological confirmation of the surgical specimen.