By Dr.Ameen Marashi
This patient has been followed up for many years because of this appearance with VA 20/20
What is your approach?!
By Dr.Lei Lei Win Choroidal naevus
exclude melanoma first.Document fundus photographs for growth, USS (localized flat or slightly elevated lesion with high internal acoustic reflectivity) ,FFA (avascular, hypofluorescence due to blockage of background choroidal fluorescence by pigmentation)..indefinite follow up
If growth is documented, the lesion should be managed as melanoma
Like a raised freckle on the skin, nevi can also occur inside your eye. The most common “choroidal nevus” or eye nevus are unusual and can only be seen by an eye care specialist. Like a nevus on the skin, a choroidal nevus can grow into a malignant melanoma.
A choroidal nevus rarely requires treatment. Photography is typically used to document the size of the choroidal nevus. If the choroidal nevus has orange pigmentation, if the nevus is leaking fluid, or has a thickness of 2 mm or more it may be (or become) a malignant choroidal melanoma.
Depending on its appearance, patients with a choroidal nevus should have their eyes examined (at least) every year. Only your doctor can look inside your eye to see if the choroidal nevus has changed. If the choroidal nevus has orange pigment or has thickened, it should be checked more often. If a choroidal nevus is leaking subretinal fluid, this is a particularly ominous sign. Such tumors should be followed most closely for evidence of growth or malignant transformation into a choroidal melanoma.
It is reasonable to have an eye cancer specialist check to see if your choroidal nevus looks suspicious. This examination may include the use of ultrasound, specialized photography or an intraocular angiogram. It is a good idea to keep a picture of your choroidal nevus. This picture can be compared to future examinations to help determine if the nevus has changed or stayed the same.