Original ArticlesAUTOFLUORESCENCE OF ORANGE PIGMENT OVERLYING SMALL CHOROIDAL MELANOMASHIELDS, CAROL L. MD; BIANCIOTTO, CARLOS MD; PIRONDINI, CESARE MD; MATERIN, MIGUEL A. MD; HARMON, SARAH A. BS; SHIELDS, JERRY A. MDAuthor Information From the Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania. Supported by the Retina Research Foundation of the Retina Society, Cape Town, South Africa (C.L.S.); the Paul Kayser International Award of Merit in Retina Research, Houston, TX (J.A.S.); a donation from Michael, Bruce, and Ellen Ratner, New York, NY (J.A.S., C.L.S.); Mellon Charitable Giving from the Martha W. Rogers Charitable Trust, Philadelphia, PA (C.L.S.); the LuEsther Mertz Retina Research Foundation, New York, NY (C.L.S.); and the Eye Tumor Research Foundation, Philadelphia, PA (C.L.S., J.A.S.). C.L.S. has had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Reprint requests: Carol L. Shields, MD, Ocular Oncology Service, Suite 1440, Wills Eye Institute, 840 Walnut Street, Philadelphia, PA 19107; e-mail: [email protected] Retina: October 2007 - Volume 27 - Issue 8 - p 1107-1111 doi: 10.1097/IAE.0b013e31814934ef Buy Metrics AbstractIn Brief Purpose: To describe the autofluorescence features of orange pigment (intracellular lipofuscin) overlying small presumed choroidal melanomas. Methods: The diagnostic testing results (fluorescein angiography, optical coherence tomography, and fundus autofluorescence imaging) for two patients with pigmented choroidal melanoma and two patients with nonpigmented choroidal melanoma were reviewed. Results: Clinically, the intracellular lipofuscin pigment appeared brown overlying the nonpigmented melanoma (two cases) and orange overlying the pigmented melanoma (two cases). Fluorescein angiography demonstrated that the lipofuscin pigment displayed fluorescein blockage in all four cases. Optical coherence tomography revealed serous retinal detachment in all four cases. Fundus autofluorescence imaging showed discrete, bright hyperautofluorescence of the orange pigment separated by hypoautofluorescent voids. The melanoma was isoautofluorescent. Conclusions: Intracellular lipofuscin overlying small choroidal melanomas shows discrete and bright hyperautofluorescence. The brightness correlates directly with the clinically visible orange pigment. Orange pigment overlying small choroidal melanoma shows bright hyperautofluorescence, contrasting with isoautofluorescence of the underlying tumor. © The Ophthalmic Communications Society, Inc.