DR. RAMYA JAYASINGH

, Dr. MAHESH P. SHANMUGAM, Dr. RAJESH RAMANJULU, Dr. DIVYANSH MISHRA

Abstract

33 yr old young male,diagnosed case of RE choroidal melanoma elsewhere & s/p plaque brachytherapy & s/p bevacizumab ,presented to us with h/o decrease in vision in RE.On examination RE vision 6/12 & IOP were 16mmhg.Fundus showed collar stud appearance of tumor in Inferotemporal quadrant & inferior arcade with surrounding SRF sparing the fovea .MRI showed hyper intense lesion on T1 & hypointense lesion on T2. fovea.Genetic analysis done showed disomy 3 & 8q amplification ,6q loss & 6p amplification indicates a risk of mets.PET scan ,USG abdomen & LFT was normal & chest x ray was normal .Patient developed radiation retinopathy with CME for which multiple antivegf & steroids was given.He was diagnosed with recalcitrant cme & toxic tumor syndrome.Patient underwent Chandelier assisted hybrid PPV+endoresection of tumor+Endocautery +PFCL+EL +SOI for the same.