9.2 RetCam™ Imaging for Specific Pediatric Intraocular Tumors |
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9.2.3 Choroidal Tumors
The two most important choroidal tumors in children include nevus and melanoma [18, 19].
9.2.3.1 Choroidal Nevus
Choroidal nevus is found in children and adults. It appears as a brown, tan, or yellow mass in the choroid, with an oval or round shape, less than 2 mm thickness [27] (Fig. 9.5). Features of overlying RPE atrophy, hyperplasia, fibrous metaplasia, osseous metaplasia, and drusen imply a chronic nevus. Features such as subretinal fluid or overlying orange
pigment imply an active mass and could represent a small choroidal melanoma. Growth of choroidal nevus into melanoma is estimated to occur at a rate of 1/5,000.
9.2.3.2 Choroidal Melanoma
Choroidal melanoma are generally found in adults, but <1% are discovered in children [28]. Choroidal melanoma is classified into small (£3 mm thickness), medium (3.1–8 mm thickness), and large (>8 mm thickness) and the mortality depends on tumor thickness. Melanoma appears as a pigmented or nonpigmented mass, often with overlying subretinal fluid (Fig. 9.5). The tumor can assume a dome,
Fig. 9.5 Choroidal tumors imaged with RetCam™. Diffuse choroidal hemangioma (a) with total serous retinal detachment confirmed on fluorescein angiography (b). (c) Choroidal nevus with overlying fibrous metaplasia of the retinal pigment epithelium. (d) Choroidal melanoma with mushroom shape in an 8-year-old girl. Large choroidal melanoma (e) with serous retinal detachment and hyperfluorescence (f) in a 6-year-old boy