Choroidal melanoma is a serious malignancy with characteristic features. Early detection and therapy is important. Pseudomelanomas can lead to diagnostic confusion; however, clinical features aid in differentiation.

Since Zimmerman's report on histopathologic features of tumors of the nonpigmented ciliary body epithelium, there have been numerous publications and further observations on the clinical features and management of these intriguing neoplasms.

Background/Aims: To investigate the efficacy of intravitreal high-dose (2.5 mg/0.1 mL) bevacizumab as rescue therapy for postradiation cystoid macular edema (CME) resistant to standard-dose (1.25 mg/0.05 mL) bevacizumab. Methods: Retrospective, interventional case series. Results: Fifteen eyes of 15 patients were included. Eyes were treated with a mean of 10 standard-dose (1.25 mg) bevacizumab injections but failed to show CME resolution. Following 3 monthly treatments of high-dose (2.5 mg) bevacizumab, mean central macular thickness (CMT) reduced significantly from 406 ± 100 to 360 ± 83 μm (p = 0.01) and mean logMAR visual acuity improved from 0.55 ± 0.17 (Snellen 20/71) to 0.48 ± 0.21 (Snellen 20/60, p = 0.07). At the final follow-up of 9 months, CMT was 395 ± 124 μm (p = 0.67) and visual acuity was 0.51 ± 0.23 (Snellen 20/65, p = 0.22). Five eyes (30%) had a >10% reduction in CMT at the final follow-up. In these eyes, the observed CMT reduction was statistically significant (p = 0.04) and logMAR visual acuity was significantly better (p ≤ 0.01) compared to the remainder of the cohort. Conclusions: Overall, the use of high-dose (2.5 mg) bevacizumab did not result in a sustained, significant improvement in CMT and visual acuity outcomes following incomplete response to standard-dose (1.25 mg) bevacizumab. However, a minority of eyes exhibited favorable response with significant CMT reduction.

Introduction  Eye pain is common and initially managed by primary care physicians. In the rare refractory case or atypical appearance, consultation with ophthalmology is needed. Case presentationA 35-year-old Hispanic male patient with a history of pterygium presented with complaints of worsening left eye pain for months .Over the past two weeks, the patient had also noticed more redness and soreness that occurred all day.  He noticed darkening in the medial vision of his left eye, persistence of left eye pain and visual changes. An excisional biopsy of the lesion was performed.  The final biopsy reports revealed an ocular surface squamous cell carcinoma in situ arising from pterygium.DiscussionTopical application and injections of immunotherapy such as mitomycin C and 5-fluorouracil have been shown to be effective.  Recurrence is high and follow-up examination by ophthalmology is essential.