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POLYPOIDAL LESIONS ASSOCIATED WITH CHOROIDAL NEVI.

Nir Gomel¹, Michaella Goldstein¹, Adrian T Fung^2,3

¹Ophthalmology Division, Tel Aviv Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Retina (Philadelphia, Pa.)

|September 25, 2023

Summary

This study analyzed polypoidal lesions on choroidal nevi, finding variable exudative activity. Treatment for these rare lesions should be individualized based on clinical presentation.

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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.