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Kirk Kohwa Hou, Vidal Soberón, Tara A McCannel; Serous Pigment Epithelial Detachments Associated with Choroidal Nevi. Invest. Ophthalmol. Vis. Sci. 2019;60(9):724.
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© ARVO (1962-2015); The Authors (2016-present)
Serous pigment epithelial defects (PEDs) are a rare finding in the setting of choroidal nevi. This retrospective case series studies the prevalence of serous PEDs overlying choroidal nevi and the long term outcomes of eyes with this unique finding from a single practitioner academic oncology practice.
All eyes with choroidal nevi from the oncology service at UCLA/Stein Eye Institute between seen between April, 2014 and May, 2018 were included for analysis in this retrospective case series. Serous PEDs were identified by Spectral-Domain Optical Coherence Tomography (SD-OCT). Choroidal nevi with poor image quality were excluded from the study.
A total of 360 eyes with choroidal nevi were included for analysis. 19 eyes (5%) with choroidal nevi had associated serous PEDs. Mean age was 64.7 ±10.2 years at the time of initial evaluation. Mean follow-up time was 3.1 ±2.1 years. Nine of 19 eyes (47% of eyes had no change in the SD-OCT over the follow-up duration. In 3 of 19 eyes (16%) eyes, serous PEDs overlying choroidal nevi were associated with choroidal neovascularization and were treated with anti-VEGF therapy (one prior to evaluation, and two during routine follow-up). One of 19 eyes (5%) developed associated subretinal fluid and orange pigment and was treated with plaque radiotherapy for presumed malignant transformation. Four of 19 eyes with serous PEDs had associated subretinal fluid without shaggy photoreceptors or obvious orange pigment and were stable without signs of progression to choroidal malignant melanoma by B scan ultrasound and fundus photos.
Serous PEDs are a rare finding associated with choroidal nevi. This finding can often be mistaken for subretinal fluid on exam, but is rarely a sign of malignancy. Often times, serous PEDs are an incidental finding, but may also signal development of choroidal neovascularization.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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