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    A patient presented with blurred vision in the right eye, with a visual acuity of 20/60 OD and 20/20 OS. Anterior segment examination was unremarkable except for cataracts. Intraocular pressure was 17 mmHg in both eyes. Posterior segment examination revealed slightly hazy media, distinct disc margins, superior rim thinning, and a large, elevated, melanotic choroidal tumor with overlying preretinal hemorrhage in the right eye. The left eye had clear media with distinct disc margins and superior rim thinning. Ultrasound of the right eye showed a dome-shaped choroidal mass with apical eruption, medium-to-low internal reflectivity, retinal detachment around the mass, and vitreous opacities. The patient underwent I-125 plaque brachytherapy with diagnostic and prognostic transvitreal FNAB for choroidal melanoma of the right eye. Over the subsequent several months, the patient developed increasing vitreous hemorrhage requiring pars plana vitrectomy and hyphema requiring anterior chamber washout. The patient also received intermittent intravitreal anti-VEGF and corticosteroid injections. Following plaque brachytherapy, the tumor demonstrated substantial regression. At 12 months post-plaque brachytherapy, visual acuity remained stable at 20/80 OD, with continued tumor regression.

    Presentation Date: 09/10/2026
    Issue Date: 09/11/2026

    • Presenter: Carlo Miguel Galang, MD URL
    • Faculty Discussant: Zelia M. Correa, MD, PhD URL

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