Tuncer Samuray, Bayramoglu Sadik
Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology, Ocular Oncology Service, Istanbul, Turkey.
Ophthalmic Surg Lasers Imaging. 2011 Apr 14;42 Online:e49-52. doi: 10.3928/15428877-20110407-02.
A 60-year-old woman was referred for a pigmented fundus lesion in her right eye that was suspected to be a possible choroidal melanoma. She complained of an intermittent floater in the right eye. Funduscopy revealed peripapillary atrophy and posterior staphyloma due to degenerative myopia, large inferior choroidal coloboma, and a cystic pigmented lesion measuring 7 mm in diameter and 3 mm in thickness located inferiorly when the patient was in the upright position. Following supine positioning, the lesion floated to the macular region. Ultrasonography confirmed that the lesion is cystic and freely mobile. Magnetic resonance imaging showed a well-defined, nodular preretinal intraocular lesion that was hypointense in both T1- and T2-weighted, non-contrast axial images. Observation of the benign vitreous cyst was advised. A free-floating pigmented vitreous cyst can be associated with high myopia and uveal coloboma. Its location in the posterior vitreous can lead to a misdiagnosis of a choroidal melanoma.
一名60岁女性因右眼眼底色素性病变前来就诊，该病变疑似脉络膜黑色素瘤。她主诉右眼有间歇性飞蚊症。眼底检查发现因退行性近视导致的视乳头周围萎缩和后巩膜葡萄肿、巨大的下方脉络膜缺损，以及患者直立位时位于下方的一个直径7毫米、厚度3毫米的囊性色素性病变。仰卧位时，该病变漂浮至黄斑区。超声检查证实该病变为囊性且可自由移动。磁共振成像显示在T1加权和T2加权非增强轴位图像上均为低信号的边界清晰的结节状视网膜前眼内病变。建议对良性玻璃体囊肿进行观察。游离漂浮的色素性玻璃体囊肿可能与高度近视和葡萄膜缺损有关。其位于玻璃体后部可能导致脉络膜黑色素瘤的误诊。
