Fig. 30.1

Small slate-grey nevus: these lesions are often slightly paler and less well defined than congenital hypertophy of the retinal pigment epithelium (ChlRPE)

Fig. 30.2

Larger nevus with changes to the overlying retinal pigment epithelium and overlying drusen.

phase hyperfluorescence. Unfortunately, however, no known non-invasive investigation can reliably differentiate a choroidal nevus from a small melanoma.

Laser Laser photocoagulation is applied to promote resolution of the subretinal fluid when serous retinal detachment threatens vision.

Review As choroidal nevi are so common, and the probability of malignant change

so low, serial examination of all choroidal nevi would be prohibitively expensive. Only lesions with suspicious clinical features require review – initiatly every 3- 6 months, and yearly thereafter. Fundus photography and ultrasonography are often used to monitor growth.
Once growth or other features suggestive of malignancy are detected in an adult, the lesion is treated as a choroidal melanoma.

Choroidal nevus