Features of choroidal naevi on swept source optical coherence tomography angiography and structural reverse flow optical coherence tomography. 2018

Zaria C Ali, and Jane Gray, and Konstantinos Balaskas
Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK.

OBJECTIVE The purpose of our study was to describe features of choroidal naevi as seen on swept source optical coherence tomography angiography (OCTA) and also on en face images derived from structural data from OCTA. METHODS A prospective observational cohort study was carried out. Patients attending a specialised choroidal naevomelanocytic with known naevi were imaged with swept source OCTA. RESULTS Seventy-one eyes of 70 patients were imaged. Forty-three patients and 44 eyes were included. Mean age was 57.7 years (SD 14.9), range 29-81 years. Male to female ratio was 20:23. On OCTA after manual segmentation, naevi could be seen in 47.6% of cases, whereas in the en face images, naevi could be clearly visualised in 79.5% of cases. In OCTA, the superficial and deep capillary plexuses appeared undisturbed as did the outer retinal layer appeared in all cases of flat naevi. In choroidal naevi with mild elevation, the outer retinal layer appeared more susceptible to projection artefacts from overlying retinal vasculature. The choriocapillaris layer showed a fading of the normal homogenous vascular mosaic corresponding to the area of the naevus. In the en face images, even the faintest and thinnest naevi could be visualised in striking detail, and naevi greater than 120 μm thickness appeared darker (p = 0.0034). CONCLUSIONS OCTA presents characteristic changes in the choriocapillaris layers in cases of choroidal naevi. The association of naevus substance appearing darker with increasing thickness may offer a novel prognostic clue. En face structural OCT may allow accurate, detailed measurement of lateral dimensions which could be of value in the monitoring of suspicious naevi.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009506 Nevus A circumscribed stable malformation of the skin and occasionally of the oral mucosa, which is not due to external causes and therefore presumed to be of hereditary origin. Mole, Skin,Moles, Skin,Skin Mole,Nevi,Skin Moles
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002829 Choroid The thin, highly vascular membrane covering most of the posterior of the eye between the RETINA and SCLERA. Choriocapillaris,Haller Layer,Haller's Layer,Sattler Layer,Sattler's Layer,Choroids
D002830 Choroid Neoplasms Tumors of the choroid; most common intraocular tumors are malignant melanomas of the choroid. These usually occur after puberty and increase in incidence with advancing age. Most malignant melanomas of the uveal tract develop from benign melanomas (nevi). Choroidal Neoplasms,Choroid Neoplasm,Choroidal Neoplasm,Neoplasm, Choroid,Neoplasm, Choroidal,Neoplasms, Choroid,Neoplasms, Choroidal
D005260 Female Females
D005451 Fluorescein Angiography Visualization of a vascular system after intravenous injection of a fluorescein solution. The images may be photographed or televised. It is used especially in studying the retinal and uveal vasculature. Fluorescence Angiography,Fundus Fluorescence Photography,Angiography, Fluorescein,Angiography, Fluorescence,Fluorescence Photography, Fundus,Photography, Fundus Fluorescence
D005654 Fundus Oculi The concave interior of the eye, consisting of the retina, the choroid, the sclera, the optic disk, and blood vessels, seen by means of the ophthalmoscope. (Cline et al., Dictionary of Visual Science, 4th ed) Fundus of the Eye,Ocular Fundus,Fundus, Ocular
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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