Background Subretinal fluid (SRF) can be associated with choroidal nevus and can cause progressive change in the morphology of overlying photoreceptors.
Methods A retrospective observational study was performed using optical coherence tomography to assess nevus and SRF features, as well as photoreceptor morphology over time.
Results There were 232 choroidal nevi that presented with or developed SRF. Photoreceptor morphology at presentation was classified as normal (n=60, 26%), shaggy (elongated) (n=73, 31%), retracted (stalactite appearance) (n=76, 33%), or absent (n=23, 10%). There was a progression in photoreceptor morphology with increasing SRF chronicity (p=0.003). For nevus presenting with normal photoreceptors and later developed SRF (n=60), photoreceptors became shaggy in 29 (48%), retracted in 24 (40%), and absent in 7 (12%) after 15, 19 and 22 months, respectively. For nevus presenting with SRF and shaggy photoreceptors (n=73), progression to retracted photoreceptors occurred in 31 (42%) after a mean of 22 months; for nevus with SRF and retracted photoreceptors (n=76), progression to absent photoreceptors occurred in 19 (25%) after a mean of 34 months; and for nevus with absent photoreceptors (n=23), photoreceptor morphology showed no change after mean follow-up of 33 months. Risk of nevus growth to melanoma was not associated with photoreceptor morphology at presentation (p=0.19).
Conclusion In eyes with choroidal nevus and SRF, there is a longitudinal evolution in photoreceptor morphology from normal to shaggy to retracted then absent with increasing SRF chronicity. SRF chronicity, as indicated by photoreceptor morphology on presentation, did not correlate with nevus growth to melanoma.
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Contributors Each of the listed authors has made substantial contributions to the intellectual content of the paper as follows. AY: Concept and design, acquisition, analysis and interpretation of data, drafting the manuscript, statistical analysis. MDY: Concept and design, acquisition, analysis and interpretation of data, drafting the manuscript, statistical analysis, critical revision of the manuscript for important intellectual content. LAD: Concept and design, acquisition, analysis and interpretation of data, drafting the manuscript, critical revision of the manuscript for important intellectual content, supervision. MM: Statistical analysis, critical revision of the manuscript for important intellectual content. SRF: Administrative, technical and material support. CLS: Concept and design, acquisition, analysis and interpretation of data, drafting the manuscript, critical revision of the manuscript for important intellectual content, supervision.
Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. Support provided in part by the Eye Tumor Research Foundation, Philadelphia, PA (CLS). The funders had no role in the design and conduct of the study, in the collection, analysis and interpretation of the data, and in the preparation, review or approval of the manuscript. CLS has had full access to all the data in the study and takes responsibility for the integrity of the data.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.
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