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choroidal nevus

Thursday 25 February 2010

Clinical differential diagnosis

- congenital hypertrophy of the pigment epithelium
- melanocytoma
- suspicious nevi

  • Suspicious nevi are defined by the presence of visual symptoms, the presence of orange pigment on the surface, the presence of subretinal fluid sometimes more visible on OCT, the presence of pin-points on angiograms, a thickness of more than 2mm, or a diameter of more than 7mm.
  • The proximity of the optic disk has also been shown to be a risk factor in several studies.
  • The factors that make the nevus suspicious are associated with a risk of malignant transformation and metastasis, which is correlated to the number of risk factors present at diagnosis.

Management

It is important to recommend close follow-up of these lesions with a check-up every 3 months (and radiotherapeutic treatment in case of growth) or early treatment if there are several risk factors and if the lesion is away from the posterior pole.

References

- Choroidal nevi. Desjardins L. J Fr Ophtalmol. 2010 Feb;33(2):136-141. (in French) PMID: #20116886#