{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:57Z","timestamp":1756339557757,"version":"3.44.0"},"reference-count":22,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,8,12]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>A male patient in his early 60s presented with sudden vision loss in his left eye during a hypertensive emergency. Ophthalmological examination showed serous retinal detachment, vitreous haemorrhage and significant suprachoroidal haemorrhage in the left eye. A post-discharge CT scan report revealed an ill-defined hyperdense structure in the left vitreous chamber, raising concerns for a potential choroidal mass. Subsequent ocular oncology evaluation, including a B-scan 8 weeks after initial assessment, demonstrated a lobulated choroidal elevation characterised by heterogeneous hyperechoic internal reflectivity and intrinsic vascularity. MRI later confirmed the presence of a well-defined intra-ocular T1 hyperintense and T2 hypointense lesion of the left eye with post gadolinium enhancement, consistent with a diagnosis of a cilio-choroidal malignant melanoma. This case underscores the importance of maintaining a high index of suspicion for choroidal melanoma in patients with unresolved suprachoroidal haemorrhage and highlights the role of MRI in challenging diagnostic cases.<\/jats:p>","DOI":"10.1136\/bcr-2024-261071","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:15:30Z","timestamp":1756314930000},"page":"e261071","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Suprachoroidal and vitreous haemorrhage during a hypertensive crisis as the presenting sign of an unsuspected cilio-choroidal melanoma"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6616-5031","authenticated-orcid":false,"given":"Mahdi","family":"Hassoun","sequence":"first","affiliation":[{"name":"Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziad","family":"Bashshur","sequence":"additional","affiliation":[{"name":"Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wajiha Jurdi","family":"Kheir","sequence":"additional","affiliation":[{"name":"Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"key":"2025082710152128000_18.8.e261071.1","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2020-240983","article-title":"Unusual presentation of a choroidal melanoma","volume":"14","author":"Jain","year":"2021","journal-title":"BMJ Case Rep"},{"key":"2025082710152128000_18.8.e261071.2","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1097\/ICU.0000000000000041","article-title":"Choroidal melanoma: clinical features, classification, and top 10 pseudomelanomas","volume":"25","author":"Shields","year":"2014","journal-title":"Curr Opin Ophthalmol"},{"key":"2025082710152128000_18.8.e261071.3","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.2147\/OPTH.S130009","article-title":"Investigation into the quantitative and qualitative characteristics of choroidal melanoma through magnetic resonance imaging and B-scan ultrasound","volume":"11","author":"Papayiannis","year":"2017","journal-title":"Clin Ophthalmol"},{"key":"2025082710152128000_18.8.e261071.4","doi-asserted-by":"crossref","first-page":"3","DOI":"10.4103\/0974-620X.94718","article-title":"Choroidal melanoma","volume":"5","author":"Singh","year":"2012","journal-title":"Oman J Ophthalmol"},{"key":"2025082710152128000_18.8.e261071.5","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajoc.2021.101173","article-title":"Hemorrhagic choroidal detachment as the presenting sign of uveal melanoma","volume":"23","author":"Chee","year":"2021","journal-title":"Am J Ophthalmol Case Rep"},{"key":"2025082710152128000_18.8.e261071.6","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1979.01020020053012"},{"key":"2025082710152128000_18.8.e261071.7","article-title":"Choroidal Melanoma: A Mini Review","volume":"10","author":"Soliman","year":"2023","journal-title":"Medicines (Basel)"},{"key":"2025082710152128000_18.8.e261071.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjo.2014.10.008"},{"key":"2025082710152128000_18.8.e261071.9","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.ajo.2003.08.044","article-title":"Hemorrhagic complication in an unsuspected macular choroidal melanoma","volume":"137","author":"Chan","year":"2004","journal-title":"Am J Ophthalmol"},{"key":"2025082710152128000_18.8.e261071.10","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S89591"},{"key":"2025082710152128000_18.8.e261071.11","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.ajoc.2018.02.001","article-title":"Hemorrhagic choroidal melanoma","volume":"10","author":"Oellers","year":"2018","journal-title":"Am J Ophthalmol Case Rep"},{"key":"2025082710152128000_18.8.e261071.12","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1007\/s00417-011-1881-8","article-title":"Massive choroidal effusion and painful secondary glaucoma from underlying uveal melanoma","volume":"250","author":"Iturralde","year":"2012","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"2025082710152128000_18.8.e261071.13","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1097\/00006982-199616060-00004","article-title":"Rhegmatogenous retinal detachment in eyes with uveal melanoma","volume":"16","author":"Haimovici","year":"1996","journal-title":"Retina (Philadelphia, Pa)"},{"key":"2025082710152128000_18.8.e261071.14","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/0002-9394(77)90853-4","article-title":"Malignant melanoma of the choroid associated with spontaneous expulsive choroidal hemorrhage","volume":"84","author":"Perry","year":"1977","journal-title":"Am J Ophthalmol"},{"key":"2025082710152128000_18.8.e261071.15","doi-asserted-by":"crossref","unstructured":"Aronow ME , Gragoudas ES . Diagnosis of choroidal melanoma. In: Albert DM , Miller JW , Azar DT , et al , eds. Albert and Jakobiec\u2019s principles and practice of ophthalmology. Cham: Springer, 2021.","DOI":"10.1007\/978-3-319-90495-5_248-1"},{"key":"2025082710152128000_18.8.e261071.16","doi-asserted-by":"crossref","DOI":"10.3390\/cancers14133147","article-title":"Imaging of Uveal Melanoma-Current Standard and Methods in Development","volume":"14","author":"Solnik","year":"2022","journal-title":"Cancers (Basel)"},{"key":"2025082710152128000_18.8.e261071.17","doi-asserted-by":"publisher","DOI":"10.1016\/0730-725X(90)90002-J"},{"key":"2025082710152128000_18.8.e261071.18","doi-asserted-by":"publisher","DOI":"10.1001\/archophthalmol.2009.208"},{"key":"2025082710152128000_18.8.e261071.19","doi-asserted-by":"publisher","DOI":"10.4274\/tjo.37431"},{"key":"2025082710152128000_18.8.e261071.20","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.jcjo.2023.07.005","article-title":"Advances in multimodal imaging for diagnosis of pigmented ocular fundus lesions","volume":"59","author":"Verbeek","year":"2024","journal-title":"Can J Ophthalmol"},{"key":"2025082710152128000_18.8.e261071.21","doi-asserted-by":"crossref","first-page":"104","DOI":"10.18502\/jovr.v15i1.5956","article-title":"Multimodal Imaging in a Case of Localized Suprachoroidal Hemorrhage","volume":"15","author":"Oli","year":"2020","journal-title":"J Ophthalmic Vis Res"},{"key":"2025082710152128000_18.8.e261071.22","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1159\/000533937","article-title":"Suprachoroidal Hemorrhage","volume":"246","author":"Mohan","year":"2023","journal-title":"Ophthalmologica"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-261071","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:15:42Z","timestamp":1756314942000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-261071"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":22,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,27]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/bcr-2024-261071"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-261071","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]}}}