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Typical electronegative electroretinography and nyctalopia as a presenting feature of systemic malignant melanoma

Authors Vercio A, Chalam KV, Winter T

Received 14 January 2019

Accepted for publication 9 July 2019

Published 13 August 2019 Volume 2019:12 Pages 265—276

DOI https://doi.org/10.2147/IMCRJ.S201500

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Abby Vercio, KV Chalam, Timothy Winter

Department of Ophthalmology, Loma Linda University School of Medicine, Loma Linda, CA, USA

Abstract: We report a unique case of a female who presented with unilateral disk edema, melanoma-associated retinopathy symptoms, and suggestive electroretinography findings preceding a diagnosis of metastatic melanoma of the pelvis. A 63-year-old female presented with complaints of seeing shimmering lights and nyctalopia, and underwent an extensive ophthalmological and electrophysiological examination. Best-corrected visual acuity was 20/20 in both eyes. Visual fields showed relative central scotomata and concentric narrowing. Slit-lamp and fundus examinations were normal. Rod-specific electroretinography responses were severely reduced, with electronegative maximal combined rod–cone responses and delayed cone responses with normal amplitude. Melanoma-associated retinopathy was suspected. Extensive systemic and internal evaluation revealed occult metastatic melanoma of the pelvis of unknown primary site.

Keywords: nyctalopia, ERG, S cone syndrome, melanoma


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