History/Chief Complaint

  • Asymptomatic 55 year old white female presented with a recently diagnosed lesion in her left eye. Multiple previous exams never noted any abnormality.

Clinical Findings

  • BCVA: OD 20/20 and OS 20/20
  • Fundus Exam: Pigmented lesion approximately 5 mm x 5 mm noted inferior to the disc OS with several large drusen, as well as some orange pigment, on the surface of the lesion. (Note that the lesion is within 3 mm of the disc, a risk factor-see page 10).

B-scan

  • No dramatic elevation in the area of the mass OS but increased echo due to a larger difference in acoustic impedance values at the site of the mass.
  • Tumor thickness on B-scan is 1.28 mm (with total thickness to external scleral border approximately 2.04 mm).

OCT Image

  • Dome shaped subretinal lesion, resulting in retinal elevation.
  • Using an OCT caliper, the maximum retinal elevation was estimated to be about 250 u.
  • Normal photoreceptor integrity line, PIL (see page 14) outside the lesion and a somewhat variably attenuated PIL in sections through the lesion.