Multimodal Imaging in Indolent Nonprogressive Multifocal Choroidal Lesions: A Case Report

Indolent nonprogressive multifocal choroidal lesions are rare benign lymphoid infiltrative disorders confined to the choroid. A 53-year-old asymptomatic man was incidentally found to have a hyperdense lesion adjacent to the left optic nerve on head computed tomography. Fundus examination revealed multiple deep yellow-orange choroidal lesions bilaterally. Fluorescein angiography demonstrated late-phase staining in some lesions, whereas indocyanine green angiography showed more extensive hypofluorescent areas than were visible on color fundus imaging. Swept-source optical coherence tomography (OCT) demonstrated multiple hyporeflective cavernous lesions within the choroid. Wide-field OCT angiography revealed patchy choroidal flow signal alterations with mild attenuation in the overlying choriocapillaris, without abnormalities in the retinal capillary plexuses. Wide-field multimodal imaging facilitated noninvasive characterization and longitudinal assessment of this rare condition, which is particularly important given the lack of established diagnostic criteria and the need for accurate differentiation from other choroidal diseases.