Question: Can you identify this condition?

A 54-year-old white woman with a history of breast cancer presents to the emergency department with visual distortion in the left eye. Her visual acuity is 20/20 in each eye. No relative afferent pupillary defect is detected and confrontational visual fields are full. A dilated fundoscopic examination reveals a lesion in the macular region of the left eye. Ensuing A-scan ultrasonography reveals a choroidal lesion with medium internal reflectivity.

The most likely diagnosis is

1. Choroidal melanoma

2. Central serous chorioretinopathy

3. Choroidal metastasis

4. Choroidal nevus

Answer on page 287

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