Choroidal Nevus

Background

A choroidal nevus is a collection of pigmented or non-pigmented cells in the choroid, the vascular layer of the eye. Nevus is essentially a medical word for freckle or mole. The word nevi refers to multiple freckles.

Choroidal nevi are very common, especially in Caucasian patients, maybe as common as 1 in every 10 people.

In about 5% of patients, choroidal nevi can be associated with a genetic abnormality, which can be detected by doing blood work. Patients with this genetic abnormality are more likely to have a freckle/nevus that becomes a true cancer and are also at risk of developing other (non-ocular) cancers.

Generally, choroidal nevi do not require treatment. They are observed over time in order to assess whether they are growing (and therefore acting biologically more like a choroidal melanoma, a malignant cancer). They are tracked with detailed imaging tests such as ultrasound, photographs, and other forms of testing in order to measure them with great detail. Sometimes a biopsy is necessary in order to determine how aggressive the cells in the tumor are.

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Overall, only a small percentage do grow. Over the years, we have learned to identify which clinical features are found more commonly in nevi that do grow into melanomas.

Features which make nevi more high-risk include:

  • Thickness > 2 mm
  • Visual symptoms
  • Orange pigment
  • Lack of features signaling chronicity
  • Certain features on ultrasound
  • Fluid under the retina
  • Location next to the optic nerve

Depending on how many of these features your nevus has, our team will decide how frequently you need to be seen in our office.

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