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T. H. Hong, P. Mitchell, E. Rochtchina, S. Cugati, T. Y. Wong, J. J. Wang, Blue Mountains Eye Study; Changes in Choroidal Nevi Over 10 Years in an Older Population. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3734.
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© ARVO (1962-2015); The Authors (2016-present)
To examine changes in the size and characteristics of choroidal nevi over 10 years in an older population.
The Blue Mountains Eye Study examined 3654 participants aged 49+ years during 1992-4. Choroidal nevi were identified from baseline retinal photographs, which were repeated after 5 and 10 years, using the same fundus camera and fields. These were graded side by side together with baseline photos by the same grader and grading procedures. Nevi were measured for size, shape and color on the baseline and follow-up photos using Scion Image software. The maximum diameter and surface area of each nevus were measured. Enlargement in nevus size was defined when surface area increased by at least 33% in follow-up photos.
The nevus prevalence at the baseline examination was 6.5%. 165 choroidal nevi were documented in 145 participants, who were seen at both the baseline and 10-year follow-up examinations. Two or more nevi were found in 16 (11%) participants; one participant had 4 nevi in one eye. The mean nevus diameter was 1.9± 0.9mm (range 0.1-5.0mm) at baseline and 2.0±0.9mm (range 0.2-5.1mm) after 10 years, with a mean change of 0.1±0.3mm in maximum diameter over the 10-year period (p=0.1). The mean surface area was 2.2 ± 2.3mm² (range 0.01-15.9 mm²) at baseline and 2.4±2.5mm² (range 0.2-16.0 mm²) after 10 years, with a mean change of 0.2±0.6mm² over the same period in area (p=0.07). Enlargement in the surface area of individual nevi was documented for 8 nevi (4.5%) (mean 1.7±2.2mm² enlargement) including one nevus that exhibited an apparent increase in nevus surface area from 4.9 to 6.6mm², and the area occupied by overlying drusen increased from 34% to 44% of the surface area. The majority (87%) of nevi were slate blue in color, with no apparent color change over time. Neither orange pigment nor subretinal fluid over the nevi or in surrounding areas were observed at either visit in any nevi.
In this older population, <5% of choroidal nevi enlarged by one third or more of its original surface area over 10 years. No nevus progressed to features suggestive of choroidal melanoma over this 10-year period of follow-up.
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