Chorodial nevi will not cause a visual dysfunction a majority of the time but it can lead to a decrease in vision if there is compression of the choriocapillaris. That will lead to RPE and Photoreceptor degeneration.
They are benign neoplasms of melanocytes in the outer layers of the choroid that are found in 5-10% of the general population.
They can be measured with a B-scan
When you find them you should refer the pt to their PCP in order to get the following tests: CBC, Liver enzyme panel, CT or ultrasound of the abdomen/liver.
TTT(transpupillary thermal therapy)
Radiotherapy - plaque brachytherapy
Proton Beam radiation
Patient complaints about flashes and floaters and other visual symptoms
Presence of drusen or RPE changes
Presence of Lipofuscin
9. B-Scan shows a solid mass with acoustic hallow area/low internal reflectivity
10. Mottled hyperfluorescence in the early stage and intense/progressive hyperfluorescence in the late stages of an FA
Metastatic tumors are usually multifocaland multilobular while chorodial melanomas are singular.
A B-scan will show a Metastic Tumor as possessing high internal reflectivity while a chorodial melanoma has low internal reflectivity
Both chorodial melanomas and Metastic Tumors can have characteristic sign known as a Leopard Skin in which brown pigment is overlying the lesion.
Treatment for metastatic tumors and chorodial melanomas is the same
Lacunae usually cause the visual field defect if the CHRPE is in the posterior pole. Similar as the nevi because you have damage or drop out of the RPE, damage to the choriocapillaris which can give you a visual field defect.
Grouped CHRPE lack lacunae, are typically smaller and be referred to as bear tracks
Multiple CHRPE is associated with Familial; Adenomatous Polyps and come in various sizes and shapes.
When you evaluate CHRPEs, if you look at it with fundus lens in the periphery, a lot of the time you will see floaters, vitreal condensation over the area which indicates an inflammatory event that happened around there which is an indication of CHRPE. Because of the condensation over that area the pt is at risk of retinal breaks so they need to be watched.
The presence of multiple discrete yellow placoid lesions that are usually bilateral
A benign growth, a vascular tumor, very well-defined, elevated and looks orange-red in appearance. It is large in size, can get sub-retinal fluid like in choroidal melanoma. At the posterior pole, it is unilateral. The one systemic disease it is associated with Sturge-Weber Syndrome (Port Wine stain).
Inflammatory material that develops into a little ball inside the retina.
Calcification of the retina, or more so in the choroid. It comes from the bones in the body
Peripheral Cystoid Degeneration (RP clumping)