Stephanie J Weiss1,2, Christina Stathopoulos1,3, Carol L Shields1. 1. Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. 2. Retina Service, Department of Ophthalmology, Weill Cornell Medical College, New York, New York, USA. 3. Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, Lausanne, Switzerland.
Abstract
PURPOSE: Choroidal nevus can cause overlying chronic retinal pigment epithelium (RPE) degenerative features, but frank retinal invasion is exquisitely rare. PROCEDURES: This is a retrospective review of 8 cases of choroidal nevus with retinal invasion with evaluation of clinical and imaging features. RESULTS: At the time of diagnosis of choroidal nevus with retinal invasion, mean patient age was 65 years. Mean tumor basal diameter was 7 mm, and mean thickness was 2.3 mm. Retinal invasion was ophthalmoscopically visible in all eyes. Related features included drusen (n = 4/8) and RPE fibrous metaplasia (n = 2/8). Overlying lipofuscin, subretinal fluid, RPE detachment, and retinal edema were absent. On B-scan ultrasonography, the lesion was dome-shaped (n = 7/7) and echo-dense (n = 6/7). Optical coherence tomography demonstrated outer retinal invasion (n = 8/8) with additional inner retinal invasion (n = 3/8). The tissue was hypoautofluorescent at the site of invasion (n = 6/7). Over a mean follow-up of 40 months, tumor enlargement was detected in 2 eyes and managed with observation (< 1 mm enlargement) or plaque radiotherapy (5 mm enlargement). Nevus hypoautofluorescence was correlated with nevus stability (p = 0.035). CONCLUSION: Retinal invasion of the choroidal nevus is rare. In this series of 8 cases, only 1 demonstrated transformation to melanoma over a mean interval of 40 months. Long-term monitoring of such lesions is warranted.
PURPOSE: Choroidal nevus can cause overlying chronic retinal pigment epithelium (RPE) degenerative features, but frank retinal invasion is exquisitely rare. PROCEDURES: This is a retrospective review of 8 cases of choroidal nevus with retinal invasion with evaluation of clinical and imaging features. RESULTS: At the time of diagnosis of choroidal nevus with retinal invasion, mean patient age was 65 years. Mean tumor basal diameter was 7 mm, and mean thickness was 2.3 mm. Retinal invasion was ophthalmoscopically visible in all eyes. Related features included drusen (n = 4/8) and RPE fibrous metaplasia (n = 2/8). Overlying lipofuscin, subretinal fluid, RPE detachment, and retinal edema were absent. On B-scan ultrasonography, the lesion was dome-shaped (n = 7/7) and echo-dense (n = 6/7). Optical coherence tomography demonstrated outer retinal invasion (n = 8/8) with additional inner retinal invasion (n = 3/8). The tissue was hypoautofluorescent at the site of invasion (n = 6/7). Over a mean follow-up of 40 months, tumor enlargement was detected in 2 eyes and managed with observation (< 1 mm enlargement) or plaque radiotherapy (5 mm enlargement). Nevus hypoautofluorescence was correlated with nevus stability (p = 0.035). CONCLUSION: Retinal invasion of the choroidal nevus is rare. In this series of 8 cases, only 1 demonstrated transformation to melanoma over a mean interval of 40 months. Long-term monitoring of such lesions is warranted.
Authors: Sanket U Shah; Swathi Kaliki; Carol L Shields; Sandor R Ferenczy; Sarah A Harmon; Jerry A Shields Journal: Ophthalmology Date: 2012-01-31 Impact factor: 12.079
Authors: Tatyana Milman; Dan-Ning Hu; Steven A McCormick; Ralph C Eagle; J Brooks Crawford; Kimberly Chin; Carol L Shields; Jerry A Shields; Devron H Char; Paul T Finger Journal: Melanoma Res Date: 2012-04 Impact factor: 3.599
Authors: Carol L Shields; Arman Mashayekhi; Miguel A Materin; Caesar Kyle Luo; Brian P Marr; Hakan Demirci; Jerry A Shields Journal: Retina Date: 2005 Apr-May Impact factor: 4.256
Authors: Carol L Shields; Minoru Furuta; Arman Mashayekhi; Edwina L Berman; Jonathan D Zahler; Daniel M Hoberman; Diep H Dinh; Jerry A Shields Journal: Ophthalmology Date: 2007-12-11 Impact factor: 12.079
Authors: Lamis Al Harby; Mandeep S Sagoo; Roderick O'Day; Gordon Hay; Amit K Arora; Pearse A Keane; Victoria M-L Cohen; Bertil Damato Journal: Ocul Oncol Pathol Date: 2021-03-15
Authors: Kelsey A Roelofs; Roderick O'Day; Lamis Al Harby; Amit K Arora; Victoria M L Cohen; Mandeep S Sagoo; Bertil Damato Journal: Cancers (Basel) Date: 2020-05-21 Impact factor: 6.639