title: Cancer-associated nummular loss of the pigment epithelium.
abstract: OBJECTIVE
  To report a case of bilateral diffuse uveal melanocytic proliferation (BDUMP) that had areas of retinal pigment epithelial loss.
  
  
  METHODS
  Observational case report.
  
  
  METHODS
  A 67-year-old woman with a history of uterine cancer presented with 4 months of bilateral visual loss.
  
  
  RESULTS
  Although B-scan ultrasonography revealed both small shallow serous retinal and choroidal detachments in the periphery, the choroid was normal in thickness. Fluorescein angiography revealed numerous nummular-shaped areas of transmission defects suggesting retinal pigment epithelium loss. Autofluorescence photography showed complete absence of autofluorescence in these nummular areas, and optical coherence tomography showed segmental areas with lack of any signal from affected areas of the retinal pigment epithelium, suggesting complete loss of retinal pigment epithelium cells.
  
  
  CONCLUSIONS
  Although the fundus findings in BDUMP have been attributed to the proliferation of uveal melanocytic cells in the outer choroid in previous papers, our patient had nummular areas of loss of the retinal pigment epithelium as the apparent reason for visual decline.
authors.affiliation: Vitreous, Retina, Macula Consultants of New York, 460 Park Avenue, New York, NY 10021, USA.
authors.forename: Simon
authors.initials: S
authors.lastname: Wu
authors.forename: Jason S
authors.initials: JS
authors.lastname: Slakter
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Shields
authors.forename: Richard F
authors.initials: RF
authors.lastname: Spaide
mesh_terms: D000368:Aged; D049109:Cell Proliferation; D015862:Choroid Diseases / Q000000981:diagnostic imaging; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008544:Melanocytes / Q000473:pathology*; D010257:Paraneoplastic Syndromes / Q000175:diagnosis*; D010857:Pigment Epithelium of Eye / Q000473:pathology*; D012163:Retinal Detachment / Q000000981:diagnostic imaging; D041623:Tomography, Optical Coherence; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000473:pathology*; D014603:Uveal Diseases / Q000175:diagnosis*; D014786:Vision Disorders / Q000175:diagnosis; D014792:Visual Acuity