Vitreous & Retina

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tumor / Others
Choroidal Nevus

  • Benign choroidal developmental tumors that composed of melanocytes.
  • Clinical features:
    • Dark gray - brownish pigmented, flat or minimally elevated lesion with slightly well demarcated margin, which size is mostly not greater than a disc diameter
    • Commonly associated with overlying Bruch's membrane changes, drusen depositions, RPE clumping or migration, serous detachment of the sensory retina or the RPE
    • Geographic patches of orange pigment may overlie the nevi, but may also be an early sign of a malignant transformation of the lesion
    • May be surrounded by a yellowish ring (halo nevus)
    • Choroidal neovascularization membrane associated with exudation or hemorrhage may develop.
  • Fluorescein angiography:
    • Angiographic features will vary depend on the degree of pigmentation
    • Deeply pigmented nevi will be relatively hypofluorescent, while less pigmented are tend to be hyperfluorescent
    • When the nevi encroaches or replaces part of the choriocapillaris, the lesions may appear hypofluorescence
    • Thicker nevi with overlying drusen will be hyperfluorescent
    • Deep-setting nevi that spare choriocapillaris will give relatively normal fluorescent
  • A-scan may have some value in diagnosing elevated lesions.
  • Management:
    • Ophthalmic examination follow-up with serial fundus photography, ultrasonography or fluorescein angiography.
    • Photocoagulation when choroidal neovascularization developed.

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