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Photo Essay |

Metastatic Cutaneous Melanoma Involving the Retina and Vitreous

Rahul N. Khurana, MD; Vinh T. Tran, MD, PhD; Narsing A. Rao, MD
Arch Ophthalmol. 2007;125(9):1296-1297. doi:10.1001/archopht.125.9.1296.
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A 76-year-old white man with an unremarkable medical history was seen with a 5-month history of floaters and painless loss of vision. Best-corrected visual acuity was 20/100 OD and 20/25 OS. Slitlamp examination of the right eye was remarkable for pigmented cells in the anterior chamber and vitreous. Funduscopy of the right eye revealed preretinal pigmentation in the posterior pole that tracked along the vascular arcades and in the periphery (Figure 1). Fluorescein angiography showed blockage secondary to the pigment deposits (Figure 2). The left eye was unremarkable. The patient underwent excision of the pigmented epiretinal membrane over the macula through pars plana. Postoperatively, the patient's visual acuity did not improve. Histologically, the specimen showed pigmented epithelioid and spindle melanoma cells (Figure 3). The patient was subsequently found to have primary cutaneous melanoma on his back with multiple metastases to the brain. The patient declined treatment and died 6 months later.

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Figure 1.

Composite fundus photograph of the right eye shows pigmentation in the posterior pole that tracked along the vascular arcades. There were also pigment deposits over the fovea and disc and in the periphery.

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Figure 2.

Fluorescein angiography of the right eye reveals blockage secondary to the pigment deposits along the arcades, fovea, and disc.

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Figure 3.

Hematoxylin-eosin staining of the epiretinal membrane shows the presence of epithelioid and spindle melanoma cells.

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