Choroidal Nevus

Choroidal Nevus

  • Benign choroidal developmental tumors that composed of melanocytes.

Clinical features:

  • Dark gray - brownish pigmented, flat or minimally elevated lesion with slightly well demarcated margin, which size is mostly not greater than a disc diameter
  • Commonly associated with overlying Bruch's membrane changes, drusen depositions, RPE clumping or migration, serous detachment of the sensory retina or the RPE
  • Geographic patches of orange pigment may overlie the nevi, but may also be an early sign of a malignant transformation of the lesion
  • May be surrounded by a yellowish ring (halo nevus)
  • Choroidal neovascularization membrane associated with exudation or hemorrhage may develop.

Fluorescein angiography:

  • Angiographic features will vary depend on the degree of pigmentation
  • Deeply pigmented nevi will be relatively hypofluorescent, while less pigmented are tend to be hyperfluorescent
  • When the nevi encroaches or replaces part of the choriocapillaris, the lesions may appear hypofluorescence
  • Thicker nevi with overlying drusen will be hyperfluorescent
  • Deep-setting nevi that spare choriocapillaris will give relatively normal fluorescent
  • A-scan may have some value in diagnosing elevated lesions.

Management:

  • Ophthalmic examination follow-up with serial fundus photography, ultrasonography or fluorescein angiography.
  • Photocoagulation when choroidal neovascularization developed.