Abstract
Purpose :
To evaluate choroidal nevi characteristics using multimodal imaging and to assess the prevalence of subretinal fluid by enhanced-depth imaging optical coherence tomography (EDI-OCT).
Methods :
Prospective observational study of consecutive patients diagnosed with choroidal nevi at the Eye Clinic, Luigi Sacco Hospital (Milan, Italy) from May 2018 to November 2018.
All patients underwent a complete ophthalmic examination including best corrected visual acuity (BVCA), color fundus photography (Canon CX-1; Canon, Tokio, Japan), 488 nm blue fundus autofluorescence (FAF) and EDI-OCT using the HRA+OCT Spectralis module (Heidelberg Engineering, Germany) and B-scan ultrasonography (Aviso S, Quantel Medical, France).
Clinical data including BCVA, position and maximum diameter of the lesion, clinical evidence of orange pigment and subretinal fluid (SRF) were recorded. Main EDI-OCT features included tumor thickness, prevalence and quantification of SRF. FAF pattern, and US features including echodensity, thickness and visibility of SRF were also analysed. Lesions suspected to be a melanoma or showing a secondary choroidal neovascularization were excluded.
Results :
73 eyes were included in the study. All patients were Caucasian with a mean age of 67.99±12.82 years.
The 96% of the nevi were pigmented whereas 4% were amelanotic. At fundoscopy, 46.6% of nevi were located within 3 mm from the optic disc and mean maximal diameter was 3.02±1.39mm; orange pigment was documented in 1 eye (1.37%) and no cases showed obvious SRF. At FAF, the 41% of nevi resulted iso-AF, 32% showed mixed AF, 25% was hypo-AF and 3% was hyper-AF. At OCT, average thickness was 417 µm (range 138-1633). SRF was found in 4 cases (5.5%) with a maximal depth of 150.80 ± 105.98 µm, maximal horizontal diameter of 1898.75±1624.31 µm and a vertical diameter equal to 1563.75 ± 2170.87 µm. The 60% of the nevi appeared flat on US; in the remaining cases (40%) mean thickness was 1.41±0.61mm. SRF was not appreciable in any case.
Conclusions :
Choroidal nevi require regular follow up documentation. Our results confirmed the role of EDI-OCT in the visualization of nevi thinner than 1 mm and showed the overall greatest sensibility of OCT in detecting SRF compared to US and clinical examination.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.