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Choroidal nevus with retinal invasion, clinical and imaging features
Juan P Fernandez1, Asghar A Haider1, Miguel A Materin1
1Department of Ophthalmology, Duke University, Durham, NC, USA.
American Journal of Ophthalmology Case Reports
|March 29, 2021
Summary
This case report details a choroidal nevus with retinal invasion, emphasizing diagnostic features and long-term monitoring. Recognizing these signs is crucial for accurate diagnosis and avoiding unnecessary treatment of benign conditions.
Area of Science:
- Ophthalmology
- Medical Imaging
- Oncology
Background:
- Choroidal nevi are common benign melanocytic tumors.
- Distinguishing benign nevi from malignant melanoma is critical.
- Retinal invasion by choroidal nevi presents diagnostic challenges.
Observation:
- A 60-year-old female presented with a 10mm choroidal lesion with central retinal invasion.
- Ancillary testing including OCT and fluorescein angiography revealed Bruch's membrane extrusion and inner retinal invasion.
- The lesion showed hypoautofluorescence and blocked perfusion at the invasion site.
Findings:
- Ultrasonography confirmed a dome-shaped choroidal lesion (3.3mm thickness).
- Optical coherence tomography (OCT) demonstrated choroidal mass extrusion through Bruch's membrane.
- Fundus autofluorescence and fluorescein angiography highlighted the area of retinal invasion.
Implications:
- Accurate identification of choroidal nevi with retinal invasion is vital for appropriate management.
- This case underscores the importance of ancillary testing in diagnosis.
- Long-term monitoring is recommended for these lesions to detect any malignant transformation.
