Purchase this article with an account.
J. A. Shields, A. Mashayekhi, S. Siu, C. L. Shields; Retinal Pigment Epithelial Trough: A Sign of Senescence and Stability of Choroidal Nevi. Invest. Ophthalmol. Vis. Sci. 2010;51(13):860.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To describe the clinical features and natural course of choroidal nevi associated with retinal pigment epithelial (RPE) trough.
Retrospective review of clinical, ultrasonographic, and optical coherence tomographic findings at initial and follow-up visits.
Ninety eyes of 89 patients were studied. Median patient age was 58 years (range, 18-79 years), 87 (98%) patients were Caucasian, and 59 patients (66%) were female. The mean nevus thickness and basal diameter were 2.2 (range, 0.8-3.4) and 6.9 mm (range, 3.5-12), respectively. Eleven nevi (12%) were located in the macula, 76 (84%) between macula and equator, and 3 (3%) between equator and ora serrata. The mean nevus distance to optic disc and foveola was 4.3 (range, 0-12) and 3.6 mm (range, 0-12), respectively. At initial presentation, 83% of nevi did not have associated subretinal fluid and only 11 nevi (12%) had serous retinal detachment outside the nevus. Other features included overlying orange pigment in 8 (9%), drusen in 49 (54%), RPE atrophy in 85 (94%), RPE hyperplasia in 67 (74%), and RPE fibrous metaplasia in 33 nevi (37%).The largest and smallest basal dimensions of the RPE trough were a mean of 4.0 and 2.1 mm, respectively. The majority of RPE troughs [68 (76%)] were located inferior to the nevus, 14 (16%) at the temporal margin, 7 (8%) at the nasal margin, and only 1 (1%) at the superior margin. All troughs had RPE atrophy and 82% had RPE hyperplasia. Eighty of 90 nevi had at least 6 months of follow-up with a mean of 79 months (range, 8-464 months). One nevus (1%) transformed into frank melanoma and two other nevi (2%) showed slight increase in size and were treated as melanoma. None of the patients developed metastasis.
Choroidal nevi with associated RPE trough are thicker and larger than the average choroidal nevus seen at our service. RPE trough outside choroidal nevi results from absorption of prior long-standing subretinal fluid and should be considered a sign of senescence of choridal nevi. Despite their greater thickness and basal diameter, choroidal nevi with RPE trough are relatively stable with low rates of malignant transformation.
This PDF is available to Subscribers Only