A Solitary Choroidal Mass with Spontaneous Resolution

Abstract

Background: To report an atypical case of a transient choroidal mass lesion with spontaneous resolution. Case Presentation. A solitary choroidal mass with an overlying neurosensory retinal detachment was seen in an otherwise healthy 31-year-old female. General physical examinations and serum chemistry were unremarkable. The patient had spontaneous resolution two weeks after initial examination without treatment.

Conclusions: Inflammatory choroidal masses may be self-limited, but complete diagnostic measures must always be performed in these patients to distinguish between important causes such as tuberculosis, sarcoidosis, and tumors.

Figure 1

Initial examination of the right eye. Color fundus photo shows subretinal fluid (arrows) and elevated subretinal mass extending beyond the inferior arcade (a). Horizontal scans of optical coherence tomography (OCT) from the fovea to inferior vascular arcade shows subretinal fluid with a dome-shaped elevated choroidal mass in the macular area (b). Vertical scan of enhanced depth imaging optical coherence tomography shows a homogenous hyporeflective elevated lesion in the choroid (c). Ultrasonography shows a hyperechoic choroidal mass with medium to low internal reflectivity (d). Fluorescein angiography in the late phase shows the pooling of dye in the subretinal area and multiple hyperfluorescent dots over the lesion (e). Midphase indocyanine green angiography reveals multiple small, round, hypocyanescent dots in the posterior and midperipheral fundus (f).

Figure 2

Follow-up examinations. Optical coherence tomography two weeks after initial presentation showed improvement of subretinal fluid, decreasing the size of the choroidal mass, disruption of the ellipsoid zone, and accumulations of hyperreflective material of variable size and shape under the fovea (a) and the corresponding retina over the choroidal mass (b). Ultrasonography two weeks after the initial presentation revealed decreasing the size of choroidal mass (c). OCT one month after initial presentation showed near-complete resolution of choroidal mass and SRF, EZ restoration, and disappearance of hyperreflective materials over RPE and outer retina.