Enhanced Depth Imaging OCT of Ultrasonographically Flat Choroidal Nevi Demonstrates 5 Distinct Patterns

To characterize the enhanced depth imaging (EDI) OCT features of ultrasonographically flat choroidal nevi.

Retrospective observational study.

Patients with ultrasonographically flat choroidal nevi identified over a 3-year period.

Comprehensive eye examinations and multimodal imaging were performed every 6 to 12 months.

Lesion thickness and features, EDI-OCT findings.

A total of 102 nevi (98 patients) were included. Median follow-up was 9 months (range 0-144 months) and 1 to 8 (mean 2.1) OCTs were performed. On OCT, nevi were classified into 5 subtypes: 3.2% were "not visible," 37.2% had "hyperreflectivity confined within normal choroidal thickness," 16.0% had characteristic anteriorly bowed hyperreflectivity with "discrete" borders and cascading edges, 14.9% were "flat with posterior bowing," and 28.7% were "elevated." One nevus of the "elevated" type demonstrated clinically insignificant growth (<10% in thickness) after 22 months of follow-up.

Five distinct EDI-OCT patterns of choroidal nevi seemed flat on ultrasonography, and many demonstrated thickness and elevation not measurable on B-scan ultrasonography. Lesion thickness can be measured using EDI-OCT.