BMJ Case Reports 2017; doi:10.1136/bcr-2017-220982
  • Images in…

Ultrasound B scan: a simple tool to simplify the diagnosis

  1. Gunjan Saluja
  1. Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
  1. Correspondence to Dr Amar Pujari, dramarpujari{at}
  • Accepted 25 May 2017
  • Published 16 June 2017


Case 1: Posterior segment ultrasonography for a patient with total cataract shows a well defined mushroom-shaped mass arising from the choroid with underlying excavation. Surrounding choroid was normal; the dimensions were 6.9 mm in basal diameter and 9.3 mm in vertical height. As the ultrasonic waves pass through the mass there is progressive decrease in amplitude of the wave due to the homogeneous mass inside known as ‘Positive angle kappa’ (figure 1A). These findings are typically suggestive of a medium-sized choroidal melanoma.

Figure 1

(A) A well defined mass arising from the choroid having a high amplitude initial spike followed by progressive decline in the size of the amplitude (known as positive kappa angle) (red arrow) along with underlying choroidal excavation (yellow arrow) suggests choroidal melanoma. (B)Dome shaped, broad mounts extending from the periphery till the equator touching each …

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