108. What is cause of SRF?
A 55-year-old presented with blurred vision. Why?
The most superficial layer of the retina has a saw-toothed appearance to it, due to surface striation. This corresponded to the clinical appearance of a subtle epiretinal membrane. In the middle of the retina, there is some scattered areas of hyperreflectivity. This is consistent with intraretinal exudation. This is causing a significant shadow.
There is significant subretinal fluid and elevation of the retina from the underlying RPE. Underneath the subretinal fluid, there is an elevated lesion below the RPE. This lesion had low internal reflectivity and corresponded to a pigmented mass on clinical examination.
The patient was diagnosed with a choroidal melanoma.
Always consider a neoplastic cause in a patient who presents with subretinal fluid.
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