Presentation
Complete loss of vision in the right eye. The eye exam is suboptimal, as the light transmitting media are opaque. The patient referred for orbital MRI exam.
Patient Data
There is a well defined intraoccular soft tissue mass , seen in the upper posterolateral part of the right eye globe, eliciting high T1 and low T2 signal intensity with homogenous post contrast enhancement. measuring about 1.2 cm along its maximum axial dimension, compatible with a choroidal melanoma .
Associated retinal detachment is seen displaying intermediate T1 and low T2 signal intensity. there is slight scleral invasion .No extraocular or intracranial extension.
The yellow arrows point to the melanoma mass, with slight scleral invasion.
There is a retinal detachmemt and vitreous bleeding
Hyperechoic intraocular focci, compatible with vitreous bleeding.
V shaped hyperechoic linear structure denoting retinal detachment .
Case Discussion
The orbital MRI exam together with orbital ultrasound give complete information. They are complementary studies.