Choroidal Nevus

• Benign choroidal developmental tumors that composed of melanocytes.

Clinical Features

• Dark gray - brownish pigmented, flat or minimally elevated lesion with slightly well demarcated margin, which size is mostly not greater than a disc diameter
• Commonly associated with overlying Bruch's membrane changes, drusen depositions, RPE clumping or migration, serous detachment of the sensory retina or the RPE
• Geographic patches of orange pigment may overlie the nevi, but may also be an early sign of a malignant transformation of the lesion
• May be surrounded by a yellowish ring (halo nevus)
• Choroidal neovascularization membrane associated with exudation or hemorrhage may develop.

Fluorescein Angiography

• Angiographic features will vary depend on the degree of pigmentation
• Deeply pigmented nevi will be relatively hypofluorescent, while less pigmented are tend to be hyperfluorescent
• When the nevi encroaches or replaces part of the choriocapillaris, the lesions may appear hypofluorescence
• Thicker nevi with overlying drusen will be hyperfluorescent
• Deep-setting nevi that spare choriocapillaris will give relatively normal fluorescent
• A-scan may have some value in diagnosing elevated lesions.

Management

• Ophthalmic examination follow-up with serial fundus photography, ultrasonography or fluorescein angiography.
• Photocoagulation when choroidal neovascularization developed.