Rublin J D, Townsend J C
J Am Optom Assoc. 1981 Jun;52(6):531-3.
Using only a few tests, it was possible to differentially diagnose a benign choroidal nevus with overlying medullation. Having revealed a flat retina with no apparent mass in the area, the ultrasound B-scan initially ruled out a choroidal malignant melanoma, choroidal hemangioma, metastatic tumor and a rhegmatogenous retinal detachment. Binocular indirect ophthalmoscopy and application of the Goldmann 3-mirror gonioscopy lens revealed that the lesion was not a retinal detachment. Due to the location of the lesion, disciform macular degeneration was also ruled out. Fluorescein angiography was the final test which aided in the definitive differential diagnosis, since it was characteristic of a choroidal nevus. Even though not all possible choroidal nevi need such an extensive work-up, occasionally specialized test can aid in the differential diagnosis of benign from potentially malignant lesions.
仅通过几项检查，就有可能对伴有髓鞘形成的良性脉络膜痣进行鉴别诊断。超声B超扫描显示该区域视网膜扁平且无明显肿物，初步排除了脉络膜恶性黑色素瘤、脉络膜血管瘤、转移性肿瘤和孔源性视网膜脱离。双眼间接检眼镜检查以及使用戈德曼三面镜前房角镜检查显示该病变并非视网膜脱离。由于病变位置，盘状黄斑变性也被排除。荧光素血管造影是有助于明确鉴别诊断的最后一项检查，因为它具有脉络膜痣的特征。尽管并非所有可能的脉络膜痣都需要如此全面的检查，但偶尔专门的检查有助于鉴别良性病变和潜在的恶性病变。
