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病例系列:脉络膜痣上方的视网膜色素上皮脱离——其临床意义是什么?

Case Series: Retinal Pigment Epithelial Detachments Over Choroidal Nevi - What Is the Clinical Significance?

作者信息

Shabto Julie M, Wells Jill R, Grossniklaus Hans E, Azarcon Corrina P

机构信息

Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.

Department of Ophthalmology, University of Texas Health Science Center San Antonio, San Antonio, TX, USA.

出版信息

Ocul Oncol Pathol. 2025 Jul;11(2):125-131. doi: 10.1159/000542860. Epub 2025 Jan 30.

Abstract

INTRODUCTION

Retinal pigment epithelial detachment (PED) is an uncommon finding associated with choroidal nevi. In this case series, we describe PED overlying a choroidal nevus in 4 patients and discuss the clinical significance of this diagnosis.

CASE PRESENTATIONS

Four adult patients diagnosed with unilateral choroidal nevi with associated overlying PEDs were followed over time. Two patients were referred for evaluation due to concerns about potential growth. Fundus photography, B-scan ultrasonography, and optical coherence tomography were performed in all cases. None of the patients developed visual symptoms attributable to the choroidal nevus or PED. No progression or malignant transformation was observed during follow-up.

CONCLUSION

While PED does not appear to increase the risk of progression to melanoma, it may complicate the evaluation of the underlying choroidal nevus and could lead to decreased visual acuity. Therefore, choroidal nevi with overlying PED should be monitored over time, with particular attention to the potential development of secondary choroidal neovascularization.

摘要

引言

视网膜色素上皮脱离(PED)是一种与脉络膜痣相关的罕见表现。在本病例系列中,我们描述了4例脉络膜痣上方出现PED的情况,并讨论了这一诊断的临床意义。

病例介绍

对4例诊断为单侧脉络膜痣并伴有上方PED的成年患者进行了长期随访。2例患者因担心潜在生长而转诊进行评估。所有病例均进行了眼底照相、B超检查和光学相干断层扫描。所有患者均未出现与脉络膜痣或PED相关的视觉症状。随访期间未观察到进展或恶变。

结论

虽然PED似乎不会增加进展为黑色素瘤的风险,但它可能会使对潜在脉络膜痣的评估复杂化,并可能导致视力下降。因此,应长期监测脉络膜痣上方伴有PED的情况,尤其要注意继发性脉络膜新生血管的潜在发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c35/12296214/5adede118a0e/oop-2025-0011-0002-542860_F01.jpg

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