Título / Title

IMPORTANCE OF ECOGRAPHY IN DIFFERENTIAL DIAGNOSIS OF RETINAL PIGMENT EPITHELIAL DETACHMENT AND MALIGNANT MELANOMA

Introdução / Purpose

The fight against pseudomelanomas, i.e. masses simulating the deadly malignant melanoma, was started by the pioneers in the field like Jerry A. Shields and Zimmerman. In the last three decades, the rate of misdiagnosis and enucleation for choroidal melanomas has been brought down from 20% to less than 1%, but this fight still continues.[1]
US can also provide useful additional information about disease detected in the ophthalmoscopic examination. It is the quickest and simplest method of imaging the eye; it is widely available, provides high-resolution images, and enables dynamic study. (2)
The objective of this study is to reveal the importance of ocular ultrasonography (US) in the differential diagnosis of pigment epithelial detachment and malignant melanoma.

Material e Método / Methods

Case description, wide-field retinography, Retinal angiography and ocular ultrasound for differential diagnosis.

Resultados / Results

Report of a 65 year old pacient with history of polipoidal maculopathy, in treatment with use of Anti-VEGF. He was refered to our clinic for evaluation of a suspected ocular melanoma in his left eye.
Wide-field retinography and angiography were realized describing a pigmented elevatad lesion superior nasal to the macula. Ultrasonography of the eye was realized in wich was observed an elevated lesion with no internal reflectivity, diagnosing a pigment epithelial detachment.

Discussão e Conclusões / Conclusion

This case reveal the importance of indicating an B-scan ultrasonography for pigmented lesions, for a more accurate differential diagnosis.
It is cost-effective, noninvasive, and reproducible, which are important considerations, especially in rural settings.[3] It has been shown to have greater than 95% accuracy in differentiating choroidal melanomas from other eye lesions. [4]

Palavras Chave

Retina; Melanoma; PED; Ultrasonography