Abstract
Purpose :
Choroidal nevus can cause overlying chronic retinal pigment epithelium (RPE) degenerative features but frank retinal invasion is exquisitely rare.
Methods :
Retrospective review of 8 cases of choroidal nevus with retinal invasion with evaluation of clinical and imaging features.
Results :
At time of diagnosis of choroidal nevus with retinal invasion, mean patient age was 65 years. Mean tumor basal diameter was 7 mm and mean thickness was 2.3 mm. Retinal invasion was ophthalmoscopically visible in all eyes. Related features included drusen (n=4/8) and RPE fibrous metaplasia (n=2/8). Overlying lipofuscin, subretinal fluid, RPE detachment, and retinal edema were absent. On B-scan ultrasonography, the lesion was dome-shaped (n=7/7) and echodense (n=6/7). Optical coherence tomography demonstrated outer retinal invasion (n=8/8) with additional inner retinal invasion (n=3/8). The tissue was hypo-autofluorescent at the site of invasion (n=6/7). Over mean follow-up of 40 months, tumor enlargement was detected in 2 eyes and managed with observation (<1 mm enlargement) or plaque radiotherapy (5 mm enlargement). Nevus hypo-autofluorescence was correlated with nevus stability (p=0.035).
Conclusions :
Retinal invasion of choroidal nevus is rare. In this series of 8 cases, only one demonstrated transformation into melanoma over mean interval of 40 months. Long-term monitoring of such lesions is warranted.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.