Optical coherence tomography angiography features of choroidal nevi

Purpose: To describe the imaging features of choroidal nevi using optical coherence tomography angiography (OCT-A) and optical coherence tomography with enhanced depth imaging (EDI-OCT). Material and Methods: Retrospective observational case series of patients with choroidal nevi. The tumor and overlying retina structural features were analyzed with EDI-OCT. The OCT-A images were evaluated for vascular changes at the level of the retinal plexus, outer retina, choriocapillaris and choroid. Statistical analysis were performed using IBM SPSS Statistics. Results and Discussion: 21 patients, 73% female, were included. The mean age was 55±10 years old. The mean tumor thickness was 359±42 µm and the mean largest basal diameter was 3089±261µm. 27% of the nevi had their epicenter at the macula. US showed a solid flat lesion with high reflectivity. With EDI-OCT all lesions appeared as a highly reflective band within the choriocapillaris with posterior shadowing. 67% of the nevi had drusen and 25% had drusenoid pigment epithelium detachment (dPED). Chronic changes in the retina were found in 52% and subretinal fluid in 16%. On OCT-A the superficial and deep capillary plexus were normal. A neovascular membrane was detected in 1 case and a polypoidal vasculopathy in 3 cases. At the level of the choriocapillaris, 16% were hyperreflective, 74% were isorreflective and 10% were hyporreflective. Conclusion: Our work demonstrated that OCT-A may be useful in the diagnosis of vascular complications associated to small stable nevi. The identification of vascularized PEDs is crucial in order to decide treatment, avoiding further visual impairment.