PMC4335608_01
Color fundus, B-scan echography, and OCT images of the left eye.. Notes: Color fundus montage photograph of the (A) superotemporal choroidal lesion (arrow heads) in the left eye with corresponding (B) standardized B-scan echography and (C) macula OCT images. The elevated choroidal mass extends to the macula in the superotemporal region with overlying chorioretinal scarring and pigmentary changes. The echography shows heterogeneous reflectivity between the scleral buckle and the underlying sclera with a maximum apical thickness of 4.96 mm (transverse section, 2 o'clock position, at the equator). There is mild corrugation of the overlying choroid and retina pigment epithelium, with marked indentation far temporally on OCT. Color fundus montage photograph in the left eye (D) with corresponding echography (E) and macula OCT images (F) at 3-month follow-up. The superotemporal lesion (D, arrow heads) is significantly less elevated with a maximum apical height of 3.37 mm on echography (transverse section, 2 o'clock position, at the equator). The macular area is now flat with minimal distortion of the choroid and retina pigment epithelium on OCT.. Abbreviation: OCT, optical coherence tomography.
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A dilated fundus exam OS suggested that there was an elevated choroidal mass in the superotemporal mid-periphery with overlying chorioretinal scarring and a buckle with moderate height (Figure 1A). Echography detected an extrascleral lesion outside the choroid between the SB and the globe centered at 2 o'clock with a maximum apical thickness of 4.96 mm (Figure 1B). Optical coherence tomography (OCT) displayed distortion of the outer retina and choroid with intact retinal pigment epithelium (Figure 1C). The choroidal indentation became progressively smaller (Figure 1D) and the visual acuity improved to his baseline of 20/40. Echography showed a decreased maximum apical height of 3.37 mm (Figure 1E). The temporal macula flattened with minimal distortion of the choroid on OCT (Figure 1F).
MRI of the orbits and brain.. Notes: (A) Axial T1 images reveal a relatively homogeneous extrascleral crescent mass centered at the posterior equator deep to the silicone scleral buckle element (arrows). (B) Coronal T1 images localize the lesion to between the scleral buckle and sclera from approximately 11.30 to clockwise 4 o'clock (arrows). (C) Schematic of the 281-type concave silicone element that was previously placed with an absolute chord length (anterior-posterior width) of 12.5 mm, consistent with in vivo MRI measurements.. Abbreviation: MRI, magnetic resonance imaging.
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Magnetic resonance imaging (MRI) of the orbits and brain revealed a relatively homogeneous crescent mass between the globe and SB (Figure 2A). Consistent with a 281-style concave silicone tire, the anterior-posterior chord length of the SB element measured 12.5 mm (Figure 2C), and extended circumferentially around the globe from 11.30 to clockwise 4 o'clock (Figure 2B).