Subclinical subretinal fluid detectable only by optical coherence tomography in choroidal naevi-the SON study.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Corporate Authors:
    • Source:
      Publisher: Nature Publishing Group Country of Publication: England NLM ID: 8703986 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-5454 (Electronic) Linking ISSN: 0950222X NLM ISO Abbreviation: Eye (Lond) Subsets: MEDLINE
    • Publication Information:
      Publication: <2003->: London : Nature Publishing Group
      Original Publication: [London : Ophthalmological Society of the United Kingdom, 1987-
    • Subject Terms:
    • Abstract:
      Background: Subretinal fluid is a risk factor for growth and malignant transformation of choroidal naevi, however it is unclear if this applies to subclinical fluid that is only detectable by optical coherence tomography (OCT). The objective of this study was to determine the prevalence and associations of subclinical but OCT-detectable subretinal fluid over choroidal naevi.
      Methods: Cross-sectional study of 309 consecutive cases of choroidal naevi imaged by OCT between July 2017 to January 2019. Multicentre international study involving ten retinal specialist centres. All patients presenting to retinal specialists had routine clinical examination and OCT imaging. The prevalence of subclinical OCT-detectable subretinal fluid over choroidal naevi and its associations with other features known to predict growth and malignant transformation were noted and analysed.
      Results: Of 309 identified consecutive cases, the mean patient age was 65 years, 89.3% of patients were Caucasian and 3.9% were Asian. The prevalence of subclinical but OCT-detectable subretinal fluid associated with choroidal naevi was 11.7% (36/309). Naevi with fluid were associated with larger basal diameters, greater thickness, presence of a halo, orange pigmentation, hyperautofluorescence, and hypodensity on B-scan ultrasonography.
      Conclusion and Relevance: Of choroidal naevi where subretinal fluid is not visible on clinical examination, 11.7% demonstrate subretinal fluid on OCT scans. These naevi more commonly exhibit features known to be associated with growth and transformation to melanoma. The presence of subclinical OCT-detectable fluid over choroidal naevi may assist in their risk stratification.
    • References:
      Sumich P, Mitchell P, Wang JJ. Choroidal nevi in a white population: the blue mountains eye study. Arch Ophthalmol. 1998;116:645–50. (PMID: 10.1001/archopht.116.5.645)
      Ganley JP, Comstock GW. Benign nevi and malignant melanomas of the choroid. Am J Ophthalmol. 1973;76:19–25. (PMID: 10.1016/0002-9394(73)90003-2)
      Singh AD, Kalyani P, Topham A. Estimating the risk of malignant transformation of a choroidal nevus. Ophthalmology 2005;112:1784–9. (PMID: 10.1016/j.ophtha.2005.06.011)
      Shields CL, Cater J, Shields JA, Singh AD, Santos MCM, Carvalho C. Combination of clinical factors predictive of growth of small choroidal melanocytic tumors. Arch Ophthalmol. 2000;118:360–4. (PMID: 10.1001/archopht.118.3.360)
      Shields CL, Furuta M, Berman EL, Zahler JD, Hoberman DM, Dinh DH, et al. Choroidal nevus transformation into melanoma: analysis of 2514 consecutive cases. Arch Ophthalmol. 2009;127:981–7. (PMID: 10.1001/archophthalmol.2009.151)
      Shields CL, Shields JA, Kiratli H, De Potter P, Cater JR. Risk factors for growth and metastasis of small choroidal melanocytic lesions. Trans Am Ophthalmological Soc. 1995;93:259–75. discussion 75-79.
      Shields CL, Dalvin LA, Ancona-Lezama D, Yu MD, Di Nicola M, Williams BK Jr, et al. Choroidal nevus imaging features in 3,806 cases and risk factors for transformation into melanoma in 2,355 cases: the 2020 Taylor R. Smith Victor T Curtin Lect RETINA. 2019;39:1840.
      Kujala E, Makitie T, Kivela T. Very long-term prognosis of patients with malignant uveal melanoma. Invest Ophthalmol Vis Sci. 2003;44:4651–9. (PMID: 10.1167/iovs.03-0538)
      Straatsma BR, Diener-West M, Caldwell R, Engstrom RE, Group* COMS. Mortality after deferral of treatment or no treatment for choroidal melanoma. J Ophthalmol. 2018;66:1395–400.
      Shields CL, Mashayekhi A, Materin MA, Luo CK, Marr BP, Demirci H, et al. Optical coherence tomography of choroidal nevus in 120 patients. Retina. 2005;25:243–52. (PMID: 10.1097/00006982-200504000-00001)
      Espinoza G, Rosenblatt B, Harbour JW. Optical coherence tomography in the evaluation of retinal changes associated with suspicious choroidal melanocytic tumors. Am J Ophthalmol. 2004;137:90–5. (PMID: 10.1016/S0002-9394(03)00868-7)
      Jonna G, Daniels AB. Enhanced depth imaging OCT of ultrasonographically flat choroidal nevi demonstrates 5 distinct patterns. Ophthalmol Retin. 2019;3:270–7. (PMID: 10.1016/j.oret.2018.10.004)
      Kaiserman I, Kaiserman N, Pe’er J. Long term ultrasonic follow up of choroidal naevi and their transformation to melanomas. Br J Ophthalmol. 2006;90:994–8. (PMID: 10.1136/bjo.2006.090738)
      Shields CL, Bianciotto C, Pirondini C, Materin MA, Harmon SA, Shields JA. Autofluorescence of choroidal melanoma in 51 cases. Br J Ophthalmol. 2008;92:617–22. (PMID: 10.1136/bjo.2007.130286)
      Shields CL, Kaliki S, Rojanaporn D, Ferenczy SR, Shields JA. Enhanced depth imaging optical coherence tomography of small choroidal melanoma: comparison with choroidal nevus. Arch Ophthalmol. 2012;130:850–6. (PMID: 10.1001/archophthalmol.2012.1135)
      Yaghy A, Yu MD, Dalvin LA, Mazloumi M, Ferenczy SR, Shields CL. Photoreceptor morphology and correlation with subretinal fluid chronicity associated with choroidal nevus. Br J Ophthalmol. 2020;104:863–7.
      Yu MD, Dalvin LA, Ancona-Lezama D, Yaghy A, Ferenczy SR, Milman T, et al. Choriocapillaris compression correlates with choroidal nevus-associated subretinal fluid: OCT analysis of 3431 cases. Ophthalmology. 2020:127:863–7.
      Shields CL, Bianciotto C, Pirondini C, Materin MA, Harmon SA, Shields JA. Autofluorescence of orange pigment overlying small choroidal melanoma. Retina 2007;27:1107–11. (PMID: 10.1097/IAE.0b013e31814934ef)
      Shields CL, Furuta M, Thangappan A, Nagori S, Mashayekhi A, Lally DR, et al. Metastasis of uveal melanoma millimeter-by-millimeter in 8033 consecutive eyes. Arch Ophthalmol. 2009;127:989–98. (PMID: 10.1001/archophthalmol.2009.208)
      Mashayekhi A, Shields CL, Eagle RC, Shields JA. Vitreous and preretinal seeding after transvitreal fine needle aspiration biopsy of choroidal melanoma. Retinal Cases Brief Rep. 2019.
      Chien JL, Sioufi K, Surakiatchanukul T, Shields JA, Shields CL. Choroidal nevus: a review of prevalence, features, genetics, risks, and outcomes. [Review]. Curr Opin Ophthalmol. 2017;28:228–37. (PMID: 10.1097/ICU.0000000000000361)
      Shields CL, Furuta M, Mashayekhi A, Berman EL, Zahler JD, Hoberman DM, et al. Clinical spectrum of choroidal nevi based on age at presentation in 3422 consecutive eyes. Ophthalmology 2008;115:546–52.e2. (PMID: 10.1016/j.ophtha.2007.07.009)
      Shields CL, Pirondini C, Bianciotto C, Materin MA, Harmon SA, Shields JA. Autofluorescence of choroidal nevus in 64 cases. Retina 2008;28:1035–43. (PMID: 10.1097/IAE.0b013e318181b94b)
    • Contributed Indexing:
      Investigator: PJ Rodriguez-Valdez; Z Cebeci; E Giancipoli; V Chaikitmongkol; M Okada; I Lains; A Sala-Puigdollers; M Ozimek; M Rehak; A Loewenstein
    • Publication Date:
      Date Created: 20201015 Date Completed: 20210709 Latest Revision: 20220531
    • Publication Date:
      20231215
    • Accession Number:
      PMC8225836
    • Accession Number:
      10.1038/s41433-020-01206-1
    • Accession Number:
      33057241