Posterior Segment
Choroidal Naevus
Also known as: choroidal naevus, choroidal nevus, pigmented choroidal lesion, flat choroidal lesion, drusen over naevus, ocular oncology monitoring
Filed as: Routine
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
Choroidal naevus is a typically benign pigmented choroidal lesion that requires documentation, risk-feature assessment, and monitoring or referral depending on suspicious features. The key clinical task is distinguishing a stable low-risk lesion from possible melanoma.
Recognition
Symptoms: what patients report
- Often asymptomatic and found incidentally.
- Symptoms are concerning if associated with subretinal fluid or macular involvement.
- New photopsia, blur, or field change should prompt reassessment.
Signs: what the examination shows
- Flat or minimally elevated grey-brown choroidal lesion.
- Overlying drusen may support chronicity.
- Absence of orange pigment, subretinal fluid, haemorrhage, and documented growth lowers concern but does not remove the need for documentation.
What OptoGuide™ covers for choroidal naevus
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Pigmented fundus lesions — College of Optometrists CMG
- New insights on circumscribed choroidal hemangioma: “bench to bedside”. Lupidi M, Centini C, Castellucci G, et al. Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische
- Circumscribed Choroidal Hemangioma: An Overview of Clinical Manifestation, Diagnosis and Management. Sen M, Honavar SG. Indian Journal of Ophthalmology. 2019;67(12):1965-1973.
- The Differential Diagnosis of Posterior Uveal Melanoma. Shields JA, Augsburger JJ, Brown GC, Stephens RF. Ophthalmology. 1980;87(6):518-22.
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.