Abstract
BackgroundTo report an association between choroidal nevus and polypoidal choroidal vasculopathy (PCV) in three patients.Case presentationWe have encountered 3 isolated patients in our center presenting with subretinal exudation and a choroidal nevus that were thoroughly evaluated by slit lamp biomicroscopy, fundus photos, Fluorescein angiography (FA), indocyanine green angiography (ICG), B-scan ultrasound, and optical coherence tomography (SD-OCT—Heidelberg). The classic features of choroidal neovascularization seen on PVC were present in all 3 patients, all of whom had a substantial response to intravitreous antiangiogenic agent. OCT, Fluorescein and ICG Angiography, and Fundus autofluorescence (FAF) revealed similar findings in all cases.Discussion and conclusionsWe have identified a clinical pattern of PCV and choroidal nevus that can be diagnosed early using fluorescein angiography, ICG and OCT.
Highlights
To report an association between choroidal nevus and polypoidal choroidal vasculopathy (PCV) in three patients.Case presentation: We have encountered 3 isolated patients in our center presenting with subretinal exudation and a choroidal nevus that were thoroughly evaluated by slit lamp biomicroscopy, fundus photos, Fluorescein angiography (FA), indocyanine green angiography (ICG), B-scan ultrasound, and optical coherence tomography (SD-OCT—Heidelberg)
We have identified a clinical pattern of PCV and choroidal nevus that can be diagnosed early using fluorescein angiography, ICG and OCT
Optical coherence tomography (OCT), fundus autofluorescence (FAF), and ocular ultrasound are tools used to examine the morphological characteristics of PCV and choroidal nevus and making it helpful in the differentiation a benign and a malignant tumor [7]
Summary
The association between a choroidal nevus and PCV is a rare but important condition [9] since it may cause substantial vision impairment as illustrated in this case series. There has been speculation that patients with choroidal nevus and PCV might have had chronic/secondary degenerative or inflammatory changes of the RPE Such changes might result in the growth of Type 1 neovascular membranes and eventually in the development of PCV adjacent to the melanocytic lesion, as we have observed in this case series. The clinical course of our patients confirmed that the associated neovascularization caused vision loss similar to the observation of Asao et al [3] Newer technologies such as OCT, FAF and ICG angiography have allowed earlier detection of choroidal neovascularization associated with choroidal nevus, as demonstrated in our series and reported by other in the peer reviewed literature [3, 7]. Our experience has shown that FAF, OCT, FA, and ICG are useful tools to identify and characterize choroidal nevus with secondary CNV and to monitor the effectiveness and response to intravitreous anti-VEGF agents in reducing exudation and improving visual acuity
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