Posterior scleritis following COVID-19 vaccination in an elderly patient

We report a case of posterior scleritis masquerading as choroidal melanoma following COVID-19 vaccination. An 86-year-old Caucasian male presented to a retina specialist with a 2-month history of blurred vision and pain right eye (OD). He received his fourth dose of the Pfizer-BioNTech COVID-19 vaccine before developing ocular symptoms. An intraocular mass was found OD and he was referred to our Ocular Oncology Service for potential choroidal melanoma with exudative retinal detachment. On examination, there was a 360-degree episcleral injection and no evidence of choroidal mass OD. Multimodal imaging confirmed no abnormality. Previous ultrasonography demonstrated an echolucent choroidal mass, likely representing choroidal effusion and minimal episcleral Tenon’s edema, suggesting posterior scleritis with spontaneous resolution over 1 week.Posterior scleritis following COVID-19 vaccination can masquerade as choroidal melanoma. In our case, the scleritis resolved spontaneously with no treatment and minimal consequences

Clinical spectrum, treatment and outcomes of uveal melanoma in a tertiary centre

INTRODUCTION@#We aimed to describe the clinical characteristics, diagnostic challenges, treatment patterns and outcomes of uveal melanoma (UM) in a tertiary care centre.@*METHODS@#This is a retrospective case series of 11 consecutive patients with UM who were managed in a tertiary referral centre between 2002 and 2017. Epidemiological, clinical, pathological and radiological characteristics were reviewed. Classification of choroidal melanoma as small, medium or large was based on the criteria established by the Collaborative Ocular Melanoma Study.@*RESULTS@#Mean age at presentation was 42.9 (range 27‒67) years. In 7 (64%) patients, a definitive diagnosis of UM was made after a mean follow-up period of 6.4 (range 1‒17) months. There were one, six and four patients with small-, medium- and large-sized choroidal melanomas, respectively. Treatment was enucleation in 5 (45.5%) patients, plaque brachytherapy in 4 (36.4%) patients, transpupillary thermotherapy in 1 (9.1%) patient, and observation in 1 (9.1%) patient. Median follow-up was 29 months. Metastatic disease developed in 5 (45.5%) patients at the mean age of 46.6 (range 38‒56) years, with median overall survival of 20 months. Genetic mutations in three patients were monosomy 3 (n = 2), and gain of 3q and 8q (n = 1).@*CONCLUSION@#Our study supports the finding that UM in Chinese and Asian Indian patients presents at a younger age than in Caucasians. Although it is rare, ophthalmologists should remain mindful of this life-threatening disease. We propose establishing a national and regional registry for ocular tumours with genetic information to characterise the disease spectrum in Southeast Asia.