Clinicopathological correlation of choroidal melanoma in Indian population: a study of 113 cases

To correlate the clinical presentation, tumor characteristics, and histopathological findings of choroidal melanoma in the Indian population A retrospective analysis of 113 patients of choroidal melanoma over a period of 10 years was done. Patient demography, clinical presentation, tumor characteristics, and histopathological findings were correlated. Among 113 patients histopathologically diagnosed with choroidal melanoma over 10 years, most were males. The mean age was 45.9 +/- 14.84 years among which 6 [5.3%] patients were less than 20 years. Thirty-six [31.8%] patients were misdiagnosed. The mean basal diameter was 12.41 +/- 1.4 mm. Mixed cell type was seen in 71 [63%] patients, while 28 [25%] patients had spindle cell type. Epithelioid cell type was present in 11 [10%] patients and necrotic cell type was seen in 3 [2%] patients. Enucleation was the primary treatment modality in 107 [94.6%] patients, while exenteration was done in 6 [5.3%] patients. Three patients with epithelioid cell type with orbital extension underwent exenteration. The mean follow-up period was 14 months. No mortality was reported at the end of 5 years in patients with longer follow-up. Malignant melanoma of the choroid is a rare occurrence. They can occur in younger age group and can be misdiagnosed. Mixed cell type is commonest. Diffuse tumors with epithelioid cell type are likely to have orbital extension

Can retinal microtrauma by internal limiting membrane peeling cause retinal angiomatosis proliferans?

A 32-year-old male presented with decreased vision in right eye since 1 month following trauma with plastic ball. Best-corrected visual acuity [BCVA] was 20/160 in right eye and 20/20 in left. Right eye examination revealed angle recession, choroidal rupture, and macular hole. He underwent vitrectomy, internal limiting membrane [ILM] peeling, and 14% C3F8 gas injection. After 6 weeks, BCVA was 20/30; fundus showed macular hole closure. Six months after surgery, fundus revealed retinal vascular lesions suggestive of stage I RAP-like lesions; vision was maintained. Clinical findings were confirmed on Video ICGA, FFA, and OCT. The patient was periodically reviewed and lesions were nonprogressive until last follow-up, 13 months after surgery. It seems quite probable that ILM peeling may have caused retinal microtrauma leading to the formation of RAP-like lesions. What factors lead to such an event is as yet not clearly understood. Hence, larger studies with a longer follow-up are warranted to better understand these findings