Giraffe Pattern of Bilateral Diffuse Uveal Melanocytic Proliferation

A 42-year-old woman with history of ovarian cancer after recent induction chemotherapy was referred for bilateral progressive vision loss of 4 months duration. On presentation, her visual acuity was 20/40 in both eyes. Funduscopic examination (Fig 1A) revealed bilateral nummular retinal pigment epithelial (RPE) clumping that with autofluorescence imaging (Fig 1B) appeared as islands of decreased autofluorescence surrounded by zones of increased autofluorescence signal in a giraffe-like pattern. The inverse was observed with fluorescein angiography (Fig 1C).