Subfoveal versus Nonsubfoveal Nevi

This 39-year-old woman’s visual acuity in both eyes was 20/20. She had no visual complaints and no history of eye diseases. Examination and ancillary testing revealed a 1 disc diameter (DD) subfoveal choroidal nevus in her right eye (yellow arrow). The yellow spots shown with blue arrows are drusen and are usually found associated with nevi that have been present for a long time. In her left eye a slightly smaller nevus measuring 0.5 DD was inferotemporal to her macula (white arrow). Optical coherence tomography (OCT) images of the right macula showed increased reflectance of the subfoveal choroid (compare the right subfoveal choroid to the left, red arrows). These choroidal nevi appear gray in color. Choroidal nevi are typically benign with no threat to vision. Uncommonly, they can cause leakage of subretinal fluid and result in metamorphopsia (wavy vision). Observation, photodocumentation, and yearly follow-ups are recommended for patients with benign choroidal nevi.