Abstract

DO.24.07

Melanocytic choroidal changes in mastocytosis

Michel B., Lang G. K.
Department of Ophthalmology, University of Ulm

Objective: Mastocytosis is a rare disease characterized by abnormal growth and accumulation of mast cells in one or more organ systems. Aggressive systemic mastocytosis is able to show ocular manifestations. Reports of ocular mastocytoma are rare.
Methods: A 37-year-old woman presented with vision loss in her left eye since two months. In addition she complained about a paracentral scotoma since one month. Since 2003 she suffered from aggressive systemic mastocytosis.
Results: At first presentation the patient had a visual acuity of 20/20 in the right eye and 20/40 in the left eye. 30-2 Perimetry showed a paracentral scotoma in the nasal superior visual field of the left eye. Funduscopy showed no pathological changes on the right eye. In the left eye a prominent melanocytic chorioidal tumor at the inferior temporal vascular arcade with orange pigment, edema and lipid exudations was found. Ultrasound showed a prominent low reflective tumor. Optical coherence tomography revealed a serous detachment of the neurosensory retina. Angiography could not be performed due to the high risk of an anaphylactic shock in mastocytosis. The most likely diagnoses are either an ocular manifestation of the mastocytosis or a choroidal malignant melanoma. A follow-up visit 3 months later showed an improvement of the visual acuity to 20/20 in the left eye and a significant reduction of the macular edema. The tumor did not show any increase of size.
Conclusions: Melanocytic chorioidal tumors in aggressive systemic mastocytosis can be an ocular mastocytoma and need to be considered in the differential diagnosis.

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