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Optomap case study – 3

In the third in a monthly series showing the benefits of ultra-widefield retinal assessment, including those of particular relevance during the current pandemic, Simon Browning describes the assessment of choroidal naevi and shows how different colour channel imaging helps to locate a pigmented lesion to a specific depth, so helping diagnosis

Ultra-widefield imaging is increasing in popularity in routine optometric practice. The many reasons for this are diverse, but broadly fall into a number of groups. These are:

The following case study demonstrates many of these benefits and demonstrates why it is essential to view the peripheral retina in all cases at all visits and how scanning laser ophthalmoscopy assist diagnosis of pigmented lesions.

A choroidal naevus is a very common finding in an otherwise normal healthy retina, present in about 1 in 20 of the general population.1 With the advent of ultra-widefield scanning laser ophthalmoscopy systems, such as Optomap, the presence of naevi has been greatly highlighted and it is not uncommon to see upwards of 80 naevi a week in a routine cohort of patients. Fortunately, the risk of a naevus converting over time to a choroidal melanoma is slight, fewer than 1 in 8,845 according to some estimates.2 However, this means that all naevi do, to some extent, pose a risk. It is, therefore, very important to be aware of their presence at all times. It is also important to have the means by which any progression can be looked for and monitored over time.

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