This case demonstrates multiple findings classic for uveal malignant melanoma.
Fundus photography show orange pigment (liposfuscin) overlying the hyperpigmented tumor.
Fundus autofluorescence (FAF) shows variable hyper- and hypoautofluorescence from the lipofuscin and chronic subretinal fluid from damaged overlying RPE.
The OCT shows homogenous thickened choroid from the tumor with variable overlying subretinal fluid.
Learning Points:
Clinical characteristics of choroidal nevi at risk for progressing to a uveal MM were described by Shields et al. (Ophthalmology 1995;102:1351-1361). The most recent version of this famous acronym, To Find Small Ocular Melanoma Doing Imaging (TFSOM-DIM, Retina 2019;39:1840-1851) is:
To (Thickness >2mm)
Find (Subretinal Fluid)
Small (Symptoms, vision <= 20/50)
Ocular (Orange pigment)
Melanoma (Melanoma hollow)
DIM (DIIaMeter >5mm)
