Pseudomelanoma at a Referral Center in Iran

Purpose: to report the diagnoses of lesions initially misdiagnosed as ocular melanoma. methods: this retrospective study included all new patients who were referred with a presumptive diagnosis of choroidal melanoma to the ocular oncology clinic at farabi eye hospital from january 2009 to december 2012. each patient underwent a full ocular examination and b-scan ultrasonography by an ocular oncologist. the final diagnosis was made based on a combination of clinical features, fluorescein angiography, indocyanine green angiography, optical coherence tomography, neuroimaging and biopsy when necessary. results: out of a total of 194 patients referred with a preliminary diagnosis of choroidal melanoma, 73 (37.6%) subjects actually had pseudomelanoma. mean age in this subgroup was 46.5±23.1 (range, 1.5-85) years. the most common entities simulating a choroidal melanoma were vasoproliferative tumors (12 cases), choroidal metastasis (11 cases), peripheral exudative hemorrhagic chorioretinopathy (10 cases), lymphoproliferative infiltrative lesions (6 cases) and melanocytoma (5 cases). conclusion: a wide range of lesions may mimic ocular melanoma; a correct diagnosis may be made by a combination of clinical examination and imaging modalities.