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Stephanie Weiss, Christina Stathopoulos, Carol L Shields; Choroidal Nevus with Retinal Invasion in 8 Cases. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1502.
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© ARVO (1962-2015); The Authors (2016-present)
Choroidal nevus can cause overlying chronic retinal pigment epithelium (RPE) degenerative features but frank retinal invasion is exquisitely rare.
Retrospective review of 8 cases of choroidal nevus with retinal invasion with evaluation of clinical and imaging features.
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).
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.
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