Subretinal Choroidal Neovascularization Associated with Choroidal Nevus

Abstract

Proliferation of a neovascular membrane on the surface of a pigmented choroidal tumor is a rare complication and is considered to be a relative indicator of a benign nature of the lesion. In the authors' experience, neovascular membranes are extrafoveal in more than half of cases and are accessible to laser photocoagulation. In contrast, the various modalities used to treat subfoveal neovascular membrane were ineffective and functional prognosis was unfavorable in these cases.

Choroidal naevi complicated by choroidal neovascular membrane and outer retinal tubulation

“…The type of CNV developing over a choroidal naevus is also variable. In previous reports most of the CNV types were either exclusively classic3 5 or exclusively occult4 or unspecified 6. In our series, choroidal neovascularisation was classic or predominantly classic in 46% of eyes (8/17) and occult or minimally classic in 53% (9/17).…”

“…However, there is a trend for a location close to the fovea in this and previous reports, as these are more likely to cause symptoms 5. CNV location over the naevus was also variable with 42% at the naevus apex and 24% towards the fovea.…”

“…In one report,6 10/17 of observed eyes with subfoveal CNV location did not receive treatment because of haemorrhage, chronicity or low visual acuity at presentation. Zografos et al 5 reported that only 4 out of 22 eyes did not receive any treatment, due to CNV self-resolution or low visual potential. In our series, nine eyes were followed up for a mean period of 8.5 months with no change in visual acuity and no significant change in the retinal thickness overlying the lesion.…”

Intravitreal Bevacizumab for Choroidal Neovascularization Associated With Choroidal Nevus

“…4 In 0.58% of choroidal nevi, 3 choroidal neovascularization (CNV) is found overlying the nevus, producing subretinal fluid or hemorrhage and retinal edema that can result in vision loss. 2,[5][6][7][8] Argon laser photocoagulation has been shown effective for the treatment of extrafoveolar CNV secondary to choroidal nevi. [5][6][7][8][9][10] However, an alternative approach is necessary when juxtafoveolar or subfoveolar CNV are encountered.…”

“…2,[5][6][7][8] Argon laser photocoagulation has been shown effective for the treatment of extrafoveolar CNV secondary to choroidal nevi. [5][6][7][8][9][10] However, an alternative approach is necessary when juxtafoveolar or subfoveolar CNV are encountered. Photodynamic therapy (PDT) with verteporfin has been used, 11 but with variable visual outcomes, perhaps owing to collateral choriocapillaris and RPE loss in the setting of multiple PDT treatments.…”