Sheep in the Skin of a Wolf, An Unusual Sub-retinal Lesion

Abstract

Purpose: To describe a case of sub retinal hemorrhage mimicking as uveal
tumour.
Material and Methods: Although new diagnostic techniques are emerging every
now and then, indirect ophthalmoscopy is still a gold standard in the diagnosis of
retino-choroidal lesions. Problems arise when media is not clear. OCT, FFA are
not possible in hazy media and fine needle aspiration cytology carries a risk of
seeding. There are other conditions like choroidal naevi, choroidal hemangiomas
and hemorrhages which can observed, but when it comes to choroidal
melanoma, it becomes very important to diagnose it in time to prevent metastatic
complication and death. A case of an 81 years old male is presented who had
vitreous hemorrhage and a sub retinal mass. Age of the patient, size of the mass
and B scan were quite confusing to exclude a choroidal malignancy. Pars plana
vitrectomy was performed and the mass proved to be a sub retinal hemorrhage
secondary to exudative age – related macular degeneration.
Key Words: Choroidal melanoma, sub retinal hemorrhage, Intra gel
hemorrhage, choroidal lymphoma, choroidal metastasis, choroidal naevus.