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Malignant Arterial Hypertension Retinopathy Revealing - A Choroidal Metastasis

Maalouf T., Kangioi-Duprez J. L.,
Service d'ophtalmologie CHU Brabois (Vandoeuvre)

A 58 year old diabetic woman was seen for an ophthalmologic examination during a malignant arterial hypertension. She complained of blurred vision of both eyes. Visual acuity was 3/10 OD and 4/10 OG. Fundus examination showed multiple haemorrhages, cotton-wool spots and papillar oedema in both eyes. In OG we observed few previsiously-known pigmented lesions in mid-temporal periphery. Near one of those pigmented lesions we discovered a new elevated 2 diac-diameter lesion with irregular pigment among it. Fluorescein angiography demonstrated an irregular hyperfluorescence of this elevated lesion. The aspect of the lesion strongly evoked a choroidal metastasis. The patient history revealed a cutaneous malignant melanoma of the arm 4 years ago. As choroidal metastasis from cutaneous malignant melanoma are very fare, a general examination and complementary exams were performed to search another cancer. They failed to find either another cancer or other metastatic lesions.

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