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Solved Unknowns

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June's Case of The Month

This 78YO male’s suspect nevus vs uveal malignant melanoma (MM) was successfully treated with initial photodynamic therapy (PDT) (due to the presence of subretinal fluid) followed by transpupillary thermotherapy (TTT) once dry. He developed a secondary branch retinal vein occlusion (BRVO), likely due to thermal damage from the TTT (arrow). BRVO’s are virtually always caused by an artery compressing a vein at a shared arteriovenous crossing. However, rarely, they can occur due to other causes, including inflammation (most commonly sarcoidosis) or secondary to interventions such as TTT. Vision is 20/30 and we continue to follow him closely. Scatter laser will be needed if he develops increasing ischemia with neovascularization from the BRVO. [This case can be found on www.retinarocks.org in the Cancer 1 Uveal malignant melanoma (MM), Uveal MM NZG-20210225]