A 42-year-old woman presented with sudden blurring of vision in her right eye of 2 weeks duration. Her best-corrected visual acuity was 20/30 OD and 20/20 OS. A systemic history revealed no pertinent findings. Her anterior segment and vitreous was normal in both eyes, and the fundus showed bilateral multiple reddish-brown patchy lesions at the macula. Fundus autofluorescence and fluorescein angiographic testing revealed the typical giraffe pattern classically described for bilateral diffuse uveal melanocytic proliferation (Figure), with bilateral submacular fluid on a spectral-domain optical coherence tomographic scan. Lesions were prominent on multicolor imaging, giving the appearance of a lake of lava. A thorough systemic workup for an occult malignant condition, including a positron emission tomographic scan, found no positive results.
Kawali AA, Bavaharan B, Mahendradas P. A Lava Lake on Multicolor Imaging of Bilateral Diffuse Uveal Melanocytic Proliferation. JAMA Ophthalmol. 2019;137(5):e185065. doi:10.1001/jamaophthalmol.2018.5065
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