Choroidal nevus with retinal invasion, clinical and imaging features
Purpose: To report a clinically challenging case of a choroidal nevus with retinal invasion with accompanying ancillary testing. Observations: A 60-year-old Caucasian female was referred for a suspicious melanocytic choroidal lesion in her left eye. Ophthalmoscopic examination revealed a melanocytic...
Main Authors: | , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Elsevier
2021-06-01
|
Series: | American Journal of Ophthalmology Case Reports |
Subjects: | |
Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993621000505 |
id |
doaj-e471d28945b64f499a02631f25f001d2 |
---|---|
record_format |
Article |
spelling |
doaj-e471d28945b64f499a02631f25f001d22021-05-22T04:38:00ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362021-06-0122101059Choroidal nevus with retinal invasion, clinical and imaging featuresJuan P. Fernandez0Asghar A. Haider1Miguel A. Materin2Department of Ophthalmology, Duke University, Durham, NC, USADepartment of Ophthalmology, Duke University, Durham, NC, USACorresponding author. 2351 Erwin Rd, Durham, NC, 27705, USA.; Department of Ophthalmology, Duke University, Durham, NC, USAPurpose: To report a clinically challenging case of a choroidal nevus with retinal invasion with accompanying ancillary testing. Observations: A 60-year-old Caucasian female was referred for a suspicious melanocytic choroidal lesion in her left eye. Ophthalmoscopic examination revealed a melanocytic choroidal lesion, measuring 10 mm × 10 mm in basal diameter. The lesion had a clinically evident area of retinal invasion seen as a protruding choroidal mass at its center, darker in appearance compared to the rest of the lesion, obscuring retinal vessels. The choroidal nevus had associated chronic retinal changes and the absence of overlying orange pigment or subretinal fluid. On fundus autofluorescence, there was a hypoautofluorescent area showing the site of retinal invasion. Fluorescein angiography at the lesion site exhibited central blocked perfusion corresponding to the area of retinal invasion. Ultrasonography showed a dome-shaped choroidal lesion that was optically dense with a medium-high internal reflectivity measuring 3.3mm in thickness. The optical coherence tomography showed a choroidal mass extruding through a break in Bruch's membrane with inner retinal invasion. A watchful waiting strategy was adopted, and at 28 months follow-up, the choroidal lesion did not show growth or presence of new suspicious features of malignant transformation. Conclusion and importance: This case highlights the importance of recognizing the key features of choroidal nevi with retinal invasion, which can prevent the treatment of a benign condition and assist in the arrival of a correct diagnosis. These lesions should be monitored for long-term.http://www.sciencedirect.com/science/article/pii/S2451993621000505ChoroidMelanomaNevusRetinal invasion |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Juan P. Fernandez Asghar A. Haider Miguel A. Materin |
spellingShingle |
Juan P. Fernandez Asghar A. Haider Miguel A. Materin Choroidal nevus with retinal invasion, clinical and imaging features American Journal of Ophthalmology Case Reports Choroid Melanoma Nevus Retinal invasion |
author_facet |
Juan P. Fernandez Asghar A. Haider Miguel A. Materin |
author_sort |
Juan P. Fernandez |
title |
Choroidal nevus with retinal invasion, clinical and imaging features |
title_short |
Choroidal nevus with retinal invasion, clinical and imaging features |
title_full |
Choroidal nevus with retinal invasion, clinical and imaging features |
title_fullStr |
Choroidal nevus with retinal invasion, clinical and imaging features |
title_full_unstemmed |
Choroidal nevus with retinal invasion, clinical and imaging features |
title_sort |
choroidal nevus with retinal invasion, clinical and imaging features |
publisher |
Elsevier |
series |
American Journal of Ophthalmology Case Reports |
issn |
2451-9936 |
publishDate |
2021-06-01 |
description |
Purpose: To report a clinically challenging case of a choroidal nevus with retinal invasion with accompanying ancillary testing. Observations: A 60-year-old Caucasian female was referred for a suspicious melanocytic choroidal lesion in her left eye. Ophthalmoscopic examination revealed a melanocytic choroidal lesion, measuring 10 mm × 10 mm in basal diameter. The lesion had a clinically evident area of retinal invasion seen as a protruding choroidal mass at its center, darker in appearance compared to the rest of the lesion, obscuring retinal vessels. The choroidal nevus had associated chronic retinal changes and the absence of overlying orange pigment or subretinal fluid. On fundus autofluorescence, there was a hypoautofluorescent area showing the site of retinal invasion. Fluorescein angiography at the lesion site exhibited central blocked perfusion corresponding to the area of retinal invasion. Ultrasonography showed a dome-shaped choroidal lesion that was optically dense with a medium-high internal reflectivity measuring 3.3mm in thickness. The optical coherence tomography showed a choroidal mass extruding through a break in Bruch's membrane with inner retinal invasion. A watchful waiting strategy was adopted, and at 28 months follow-up, the choroidal lesion did not show growth or presence of new suspicious features of malignant transformation. Conclusion and importance: This case highlights the importance of recognizing the key features of choroidal nevi with retinal invasion, which can prevent the treatment of a benign condition and assist in the arrival of a correct diagnosis. These lesions should be monitored for long-term. |
topic |
Choroid Melanoma Nevus Retinal invasion |
url |
http://www.sciencedirect.com/science/article/pii/S2451993621000505 |
work_keys_str_mv |
AT juanpfernandez choroidalnevuswithretinalinvasionclinicalandimagingfeatures AT asgharahaider choroidalnevuswithretinalinvasionclinicalandimagingfeatures AT miguelamaterin choroidalnevuswithretinalinvasionclinicalandimagingfeatures |
_version_ |
1721430820786274304 |