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Bilateral macular detachment in a 64-year-old man

Eye (2025)Cite this article

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A 64-year-old Caucasian male presented with a 2-month history of progressive, painless bilateral vision loss. Patient reported a history of renal cell carcinoma post nephrectomy one month before presentation. Best corrected Visual acuity was 20/50 in OD and 20/100 in OS. Anterior segment exam was significant for 2 + NS. Images shown are OS. Fundus exam revealed bilateral macular serous detachment (A). Fundus autofluorescence highlighted a leopard skin appearance of the posterior pole OU (B). Fluorescein angiography showed a speckled hyperfluorescence in the macula OU (C). OCT showed serous macular detachment with bacillary layer detachment OU (D). The diagnosis of bilateral diffuse uveal melanocytic proliferation (BDUMP) was made. BDUMP is a rare paraneoplastic syndrome characterized by proliferation of choroidal melanocytes due to an underlying malignancy with subsequent uveal thickening, serous retinal detachment, and cataract formation [1, 2]. Prognosis is poor. Mean survival after presentation averages around 15.7 months due to complications from primary malignancy [3].

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References

  1. Chen O, Crawford F, Raiji V. Successful treatment of bilateral diffuse Uveal melanocytic proliferation with plasmapheresis. Modern Retina. 2023;3. https://www.modernretina.com/view/successful-treatment-of-bilateral-diffuse-uveal-melanocytic-proliueration-with-plasmapheresis. Accessed 2 Feb 2025.

  2. O’Neal KR, Butnor KJ, Perkinson K, Proia AD. Bilateral diffuse uveal melanocytic proliferation associated with pancreatic carcinoma: a case report and literature review of this paraneoplastic syndrome. Surv Ophthalmol. 2003;48:613–25. https://doi.org/10.1016/j.survophthal.2003.08.005

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  3. Klemp K, Kiilgaard JF, Heegaard S, Nørgaard T, Andersen MK, Prause JU. Bilateral diffuse uveal melanocytic proliferation: case report and literature review. Acta Ophthalmol. 2017;95:439–45. https://doi.org/10.1088/2053-1591/abf19f

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Authors and Affiliations

  1. Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Dania A. Rahal, Ahmed F. Shakarchi & Sami H. Uwaydat

Authors
  1. Dania A. Rahal
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  2. Ahmed F. Shakarchi
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  3. Sami H. Uwaydat
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Contributions

DAR, AFS, SHU: manuscript writing, editing, and finalization.

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Correspondence to Dania A. Rahal.

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The authors declare no competing interests.

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Rahal, D.A., Shakarchi, A.F. & Uwaydat, S.H. Bilateral macular detachment in a 64-year-old man. Eye (2025). https://doi.org/10.1038/s41433-025-03714-4

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