POLYPOIDAL LESIONS ASSOCIATED WITH CHOROIDAL NEVI

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Choroidal nevi are common benign melanocytic tumors.
• Polypoidal lesions can occur in various retinal conditions, impacting vision.
• The association between polypoidal lesions and choroidal nevi is not well-characterized.

Purpose of the Study:

• To investigate the multimodal imaging features of eyes with polypoidal lesions overlying choroidal nevi.
• To analyze the clinical course and long-term follow-up of these specific lesions.
• To understand the potential mechanisms behind polypoidal lesion formation in this context.

Main Methods:

• Retrospective case series of 14 eyes with polypoidal lesions and choroidal nevi.
• Analysis of multimodal imaging: fundus photography, OCT, OCT angiography, FA, ICGA, and ultrasonography.
• Recording of demographic data, clinical information, and treatment outcomes over a mean follow-up of 50 months.

Main Results:

• 14 eyes (mean age 70.3 years) with polypoidal lesions on pigmented, flat choroidal nevi were studied.
• Shallow pigment epithelium detachment was common on OCT; 78.6% showed exudative activity.
• Visual acuity decreased from 20/32 to 20/50; treatments included anti-VEGF injections and photodynamic therapy.

Conclusions:

• This is the largest cohort study on polypoidal lesions associated with choroidal nevi.
• Exudative activity is variable, necessitating individualized treatment strategies.
• Choroidal ischemia, not just Haller layer hyperpermeability, may contribute to polypoidal lesion development.