Ultrasound Insights: Necrotic Choroidal Melanoma Presenting as Neovascular Glaucoma and intraocular inflammation

This report describes a case of necrotic choroidal melanoma in a 69-year-old woman presenting with neovascular glaucoma (NVG) and intraocular inflammation. Ultrasonographic evaluation, including B-scan and color Doppler imaging, revealed vitreous opacities, intraocular calcifications, necrotic areas without intralesional blood flow, and vascular bud-like signals at the scleral wall. These ultrasonographic findings provided critical diagnostic clues, distinguishing the condition from inflammatory intraocular diseases. Histopathology confirmed necrotic choroidal melanoma with over 50% necrosis and no evidence of orbital invasion. This case underscores the importance of ultrasonography in identifying necrotic choroidal melanoma presenting with NVG and inflammation.