![]() ![]() All rights reserved.The retinal pigment epithelium (RPE) is a single layer of post-mitotic cells, which functions both as a selective barrier to and a vegetative regulator of the overlying photoreceptor layer, thereby playing a key role in its maintenance. ![]() Thompson, MD SPANISH SERIES EDITORSĬopyright © The Foundation of the American Society of Retina Specialists. A nevus that has demonstrated growth or has suspicious features should be evaluated by an ocular oncologist (an ophthalmologist specializing in treating eye tumors), and if determined to be a melanoma, would most commonly be treated with radiation ( see Intraocular Melanoma Fact Sheet) (Figure 7)Īuthors THANK YOU TO THE RETINA HEALTH SERIES AUTHORS However, choroidal neovascularization associated with nevi can be treated with intravitreal injection of anti-VEGF agents (Figure 6). Most nevi do not require any specific treatment. Evaluation of these lesions would include a dilated retinal examination and possibly ultrasonography, fundus photography, and OCT. However, those with one or more risk factors should be examined approximately every 4 to 6 months. Nevi without any clinical risk features may be examined annually. This complication can cause vision loss but is not a sign of transformation into melanoma. A choroidal nevus with associated fluid and blood due to the development of abnormal vessels under the retina (choroidal neovascularization). When a nevus shows significant growth over a relatively short period of time (such as 1 year), it is presumed to have become malignant (cancerous).Ĭlinical features of a nevus associated with growth include thickness greater than 2 mm, subretinal fluid, symptoms (such as decreased vision, flashes of light, or floaters), orange pigment, and location close to the opticįigure 6. The rate of choroidal nevi transforming into melanoma is estimated at approximately 1 in 9000 per year. However, occasionally, a nevus can transform into uveal melanoma. Most choroidal nevi remain benign (non-cancerous) and have no symptoms. Less frequently, imaging techniques including indocyanine green angiography, optical coherence tomography angiography, and fundus autofluorescence photography are utilized to assist in diagnosis. Some eyes have more than one nevus, and nevi may also be found in the fellow eye. Retinal photographs of the nevus are typically performed to allow them to be monitored for any signs of growth on subsequent office visits.Īdditional diagnostic testing of larger or suspicious nevi includes optical coherence tomography (OCT), ultrasound to measure the size and thickness of elevated nevi, and fluorescein angiography. Most nevi are flat or have minimal elevation of 2 millimeters or less. This includes a brown to slate gray coloration with distinct but mildly blurred margins where the color of the nevus blends into the normal retina. Many nevi can be identified by their appearance alone on examination of the retina. ![]() When a nevus causes degeneration or dysfunction of the overlying RPE, fluid may accumulate under the retina or abnormal blood vessels ( choroidal neovascularization) may develop and bleed or leak fluid. Most commonly, a choroidal nevus does not cause any symptoms and is found on routine eye exam. However, sometimes nevi under the center of the retina (the macula) can cause blurred vision. ![]() The estimated prevalence of choroidal nevi in Asian populations has been reported at 1.8% to 2.9%. The estimated prevalence of choroidal nevi in the United States has been reported to be 5% with significant variation by race: 5.6% in White individuals, 2.7% in Hispanic populations, 0.6% in Black individuals. A slightly raised choroidal nevus with drusen (yellow dots) on surface. ![]()
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