Choroidal Nevi in Children: Size, Growth, and Topographic Distribution

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Ocular Oncology

Background:

• Choroidal nevi are common benign melanocytic tumors.
• Understanding their behavior in children is crucial for early detection and management.
• Limited data exists on pediatric choroidal nevogenesis.

Purpose of the Study:

• To investigate the size, growth patterns, and topographic distribution of choroidal nevi in children.
• To compare pediatric choroidal nevogenesis with adult data.
• To gain insights into the developmental processes of choroidal nevi.

Main Methods:

• Retrospective analysis of pediatric cases (<20 years) from the Cole Eye Institute (CEI) database and pooled population data.
• Widefield fundus imaging and topographic mapping of 18 choroidal nevi in children.
• Comparison with 100 consecutive adult cases of choroidal nevi from the CEI database.

Main Results:

• Pediatric choroidal nevi had a median basal diameter of 1.6 mm, with 16% showing growth (mean 0.12 mm/year).
• No malignant transformations were observed in children.
• Choroidal nevi were significantly more posterior in children (median 2.1 mm from fovea) compared to adults (median 5.1 mm from fovea).
• Secondary changes associated with nevi were less common in children than adults.

Conclusions:

• The observed growth and posterior distribution of choroidal nevi in children suggest active nevogenesis during this period.
• These findings support a developmental framework for melanoblast migration and maturation.
• Early-onset choroidal nevi may represent an ongoing developmental process.