Choroidal Nevus - Suspicious

This montage shows growth of a pigmented choroidal lesion in the left eye of a 66 year old male patient. This is a seven year follow up in which the nevus has grown larger as indicated by the landmarks. The yellow arrows indicate the four important borders of the nevus at the time of the given picture. The blue x’s mark the borders of the nevus as of the most recent image. Once the yellow arrows reach the “x”, they turn blue to indicate no further growth. Note the nevus first grew inferiorly as it passed the two vein crossings as well as an arterial branching. Around 2014, the inferior growth slowed down and the nevus began expanding superiorly towards the arterial bend. It also developed orange pigment (pink arrows) overlying the lesion during the seven years. Ultrasonography showed no increase in thickness. Based on an enlarging basal dimension and development of orange pigment, a recommendation to treat the lesion with I-125 plaque therapy was made.