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Meena S. George, Robert M. Beardsley, Tara A. McCannel; Clinical Characteristics Of Symptomatic Choroidal Nevi Associated With Subretinal Fluid: A Case Series. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4945.
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To describe a series of patients with symptomatic choroidal nevi and characterize their associated findings on ultrasound, fluorescein angiography, and Spectral Domain optical coherence tomography (SD-OCT) and to elucidate the characteristics that distinguish these lesions from malignant melanoma.
The records of patients identified in an ocular oncology database with symptomatic choroidal nevi were retrospectively reviewed. Patient demographics, Snellen visual acuity, Amsler grid testing, ultrasound, fluorescein angiography and SD-OCT were reviewed.
A total of six patients were identified who had symptomatic choroidal nevi. The mean age was 38 years (range, 18-80 years) and average follow up time was 1.9 years (range, 0-5 years). The most common presenting symptoms were decreased visual acuity, metamorphopsia, and visual defects. Clinical examination revealed pigmented lesions that generally lacked orange lipofuscin pigment and varied in basal diameter, ranging up to 10 mm in size. All lesions were associated with subretinal fluid, which was observed to be adjacent to the nevus, rather than tracking to the inferior fundus periphery. The average height by ultrasound was 2.19 mm (range, 1.53-3.05 mm) and typical ultrasonographic features included high reflectivity and nonvascularity. Fluorescein angiography revealed leakage over the lesions associated with late staining. SD-OCT most commonly demonstrated subretinal, often subneurosensory, fluid. On follow-up examinations, in the absence of any intervention, lesions typically remained stable.
We present a clinical case series of symptomatic yet benign choroidal nevi. Typical clinical, ultrasonographic, fluorescein angiographic and OCT characteristics are reviewed. Although rare, symptomatic choroidal nevi must be distinguished from malignant choroidal melanoma. Close observation of suspicious choroidal nevi, which may be benign, is recommended.
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