Enhanced Depth Imaging OCT of Ultrasonographically Flat Choroidal Nevi Demonstrates 5 Distinct Patterns

Purpose: To characterize the enhanced depth imaging (EDI) OCT features of ultrasonographically flat choroidal nevi. Design: Retrospective observational study. Participants: Patients with ultrasonographically flat choroidal nevi identified over a 3-year period. Methods: Comprehensive eye examinations and multimodal imaging were performed every 6 to 12 months. Main Outcome Measures: Lesion thickness and features, EDI-OCT findings. Results: A total of 102 nevi (98 patients) were included. Median follow-up was 9 months (range 0-144 months) and 1 to 8 (mean 2.1) OCTs were performed. On OCT, nevi were classified into 5 subtypes: 3.2% were not visible, 37.2% had hyperreflectivity confined within normal choroidal thickness, 16.0% had characteristic anteriorly bowed hyperreflectivity with discrete borders and cascading edges, 14.9% were flat with posterior bowing, and 28.7% were elevated. One nevus of the elevated type demonstrated clinically insignificant growth (<10% in thickness) after 22 months of follow-up. Conclusions: Five distinct EDI-OCT patterns of choroidal nevi seemed flat on ultrasonography, and many demonstrated thickness and elevation not measurable on B-scan ultrasonography. Lesion thickness can be measured using EDI-OCT. (C) 2018 by the American Academy of Ophthalmology.