April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Bilateral Uveal Pigmented Alterations With Remarkable Evolution: Long Term Follow-Up in a Case of Possible Bilateral Diffuse Uveal Melanocytic Proliferation
Author Affiliations & Notes
  • F. O. Avellis
    Institute of Ophthalmology, University of Parma, Parma, Italy
  • P. Mora
    Institute of Ophthalmology, University of Parma, Parma, Italy
  • S. Gonzales
    Institute of Ophthalmology, University of Parma, Parma, Italy
  • Y. J. Guex-Crosier
    Ophthalmology, Jules Gonin Eye Hospital, Lausanne, Switzerland
  • L. Zografos
    Ophthalmology, Jules Gonin Eye Hospital, Lausanne, Switzerland
  • Footnotes
    Commercial Relationships  F.O. Avellis, None; P. Mora, None; S. Gonzales, None; Y.J. Guex-Crosier, None; L. Zografos, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 5341. doi:
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      F. O. Avellis, P. Mora, S. Gonzales, Y. J. Guex-Crosier, L. Zografos; Bilateral Uveal Pigmented Alterations With Remarkable Evolution: Long Term Follow-Up in a Case of Possible Bilateral Diffuse Uveal Melanocytic Proliferation. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5341.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose:
 

to describe a case of probable bilateral diffuse uveal melanocytic proliferation (BDUMP) with scleral involvement, free from systemic malignancies and cataract.

 
Methods:
 

fifty months of follow up with recurrent complete ophthalmological examinations, including fundus photography, fluorescein/indocyanine green angiography (FA) and optical coherence tomography (OCT). Investigations also included an electroretinography (ERG) and histological examination of scleral biopsy. Extraocular malignancies were repeatedly searched.

 
Results:
 

the patient was a 61 year-old Italian man with chronic hepatitis type C. At first visit his best corrected visual acuity (BCVA) was 20/32 in OS and 20/25 in OD. Funduscopy showed multiple patch-shaped pigmented alterations involving macular region and mid retinal periphery. FA showed corresponding areas of late-phase hyperfluorescent pinpoints (figure 1a, OS) and intemediate-phase hypocyanescence (figure 1b, OS), with subtle serous neurosensory retinal detachment confirmed by OCT. Photopic and scotopic ERG tested normal. Systemic prednisone was administered for one month without any improvement. After ten months round pigmentary lesions appeared also in superior scleral surface of both eyes. Biopsy allowed to disclose slightly pigmented spindle cells. BCVA worsened for further 10 months, with enlargement of FA alteration areas but lenses still clear. After 30 months spontaneous coalescence and atrophy of retinal lesions started, paralleled by progressive visual recovery. At the end of our follow up BCVA was 20/25 in OU while scleral pigmentary lesions remained unchanged.

 
Conclusions:
 

we report the case of a patient with main features of BDUMP and some unusual findings. Although not all classical diagnostic criteria were fulfilled, the presence of scleral pigmented lesions and spontaneous visual recovery may enlarge clinical spectrum of the disease.  

 
Keywords: tumors • uvea • melanocytes 
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