Optometry Continuing Education

OCT Mastery - Tip of the Week

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129. Elevated Lesion

A 74-year-old presented with a flashes and floaters. Why?

Tip #128


In this image we can see elevation of the retina. In the retina, there is evidence of hyporeflective spaces in the retina, consistent with cystic fluid. This photo is taken from the peripheral retina (a few millimeters from the disc). The inner plexiform layer (IPL), and inner nuclear layer (INL) are visible. The elevation is noted to be at the level of the RPE (A). The area below the RPE is hyporeflective and is homogeneous. This patient was diagnosed with a choroidal melanoma.

In this tip's accompanying 13 min. video, Dr. Sharma takes you through additional diagnostic imagery as well as:

  • An approach to a deep retinal elevation
  • Line-by-line analysis of this OCT
  • A review of the accompanying fundus photo, angiogram and ultrasound
  • Pearls regarding how to differentiate a nevus from a melanoma
Tip #129


Patients with choroidal melanoma may present with intraretinal fluid or hemorrhage.

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