Autofluorescence of orange pigment overlying small choroidal melanoma.

PURPOSE: To describe the autofluorescence features of orange pigment (intracellular lipofuscin) overlying small presumed choroidal melanomas. METHODS: The diagnostic testing results (fluorescein angiography, optical coherence tomography, and fundus autofluorescence imaging) for two patients with pigmented choroidal melanoma and two patients with nonpigmented choroidal melanoma were reviewed. RESULTS: Clinically, the intracellular lipofuscin pigment appeared brown overlying the nonpigmented melanoma (two cases) and orange overlying the pigmented melanoma (two cases). Fluorescein angiography demonstrated that the lipofuscin pigment displayed fluorescein blockage in all four cases. Optical coherence tomography revealed serous retinal detachment in all four cases. Fundus autofluorescence imaging showed discrete, bright hyperautofluorescence of the orange pigment separated by hypoautofluorescent voids. The melanoma was isoautofluorescent. CONCLUSIONS: Intracellular lipofuscin overlying small choroidal melanomas shows discrete and bright hyperautofluorescence. The brightness correlates directly with the clinically visible orange pigment.

Duke Scholars

Author Miguel Angel Materin Ophthalmology, Vitreoretinal Diseases & Surgery