A choroidal nevus is a flat, benign, pigmented area that appears in the back of the eye. Often, this is referred to as an “eye freckle.” Eye freckles are found in a small percentage of the population (approximately 1 in 10 people).
The causes of Choroidal Nevus
A choroidal nevus is made up of cells called melanocytes which produce melanin, the pigment that colors our hair, skin, and eyes. Most of the time, melanocytes are spread evenly throughout the body. Sometimes, however, they cluster together to form a choroidal nevus, which is found under the retina in a layer of tissue called the choroid.
Are there any dangers for Choroidal Nevus?
Most choroidal nevi are harmless; however, there is a small risk for it to become cancer (i.e. choroidal melanoma, see below). Statistically, 1 in 500 choroidal nevi will undergo transformation into a malignancy within a 10-year time frame. Clinical findings such as orange color, leakage of fluid underneath the retina, and growth in size could be early signs that the nevus is transforming into a melanoma. As such, a choroidal nevus needs to be monitored regularly and carefully by an ophthalmologist.
Choroidal Nevus Treatment options
Most nevi do not need to be treated, as they do not typically affect your vision or lead to any health problems. The only reason that you may need treatment is if your ophthalmologist suspects it might be a choroidal melanoma. Thus, a detailed evaluation by a trained ocular oncologist is crucial.
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A choroidal melanoma is a type of cancer that develops in the eye and produces pigment. Pigment gives color to your skin, hair, and eyes. Just as you can develop a melanoma in your skin, you can also develop it inside the eye. Although it is the most common cancer to originate within the eye in adults, a choroidal melanoma is rare.
The causes of Choroidal Melanoma
Choroidal melanoma occurs when the DNA of the pigment cells develop errors, causing the cells to multiply out of control and eventually forming cancer. It is not clear why choroidal melanomas develop, although many suspect the cause is multifactorial, involving genetics as well as environmental exposure. People with a previously documented choroidal nevus (“eye freckle”, see above) are at higher risk. Other risk factors include lighter-colored eyes and a family history of eye cancers.
What are the implications of Choroidal Melanoma?
A choroidal melanoma is a malignant cancer within the eye. As such, it poses a significant risk to both the eye and the body. A choroidal melanoma can grow in size and spread to other areas of the eye, often causing increased blurry vision. It can also spread to other parts of the body (a process known as metastasis) by traveling through the blood circulation. Common organs that a choroidal melanoma can spread to are the liver and the lungs. If it is determined that you have a choroidal melanoma, it is essential for you to also be evaluated by a medical oncologist in addition to an ocular oncologist.
Treatment options for Choroidal Melanoma
The type of treatment that is recommended for a choroidal melanoma can vary depending on numerous factors such as size of the tumor, amount of vision that remains, whether the tumor has spread to other parts of the body, and other health conditions that may complicate surgery.
The most common form of treatment is brachytherapy, where a radioactive plaque is surgically implanted onto the eye for a duration of time and then removed. Other forms of radiation therapy include gamma knife therapy and proton beam therapy. These are performed in conjunction with a radiation oncologist.
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Congenital Hypertrophy of the Retinal Pigment Epithelium (CHRPE)
CHRPE is a flat, darkly pigmented spot found in the back of your eye. It can vary in size, ranging from a few to more than 10 mm in diameter. They are composed of enlarged cells with densely packed and larger-than-normal, spherical pigment granules. Pigment gives color to your skin, hair, and eyes.
Causes of CHRPE
You are born with a CHRPE in the eye, but it Amy go undetected until much later, often as part of a routine dilated eye examination.
The Dangers of CHRPE
While a CHRPE may grow slightly over time, it is not malignant. Thus, it does not pose a risk of spreading to other parts of your body. It rarely leads to any noticeable symptoms for your eyes; therefore, a CHRPE does not pose a risk to your vision.
This is in contrast to a choroidal melanoma (see above), which does pose a risk for malignancy and can be dangerous to your vision and overall health. Although CHRPEs and choroidal melanomas may appear similar, it is essential to have a thorough examination by an ophthalmologist to differentiate between the two.
While a single CHRPE poses no overall health risk, multiple CHRPEs in one or both eyes have been rarely associated with a genetic disease called Familial Adenomatous Polyposis (also known as Gardner Syndrome). These patients are prone to developing colon cancers and skin tumors in additional to the eye findings. If this is suspected, an evaluation by a gastroenterologist is crucial.
What are the treatment options for CHRPE?
CHRPE does not require treatment and can be monitored with repeat dilated eye examinations.
Schedule a Consultation
If you are interested in learning more about Nevus, Melanoma, and tumors, please call (800) VRS-2500 to schedule a consultation. We have locations in Minneapolis, St. Paul, Blaine, Edina, Plymouth, St. Cloud, and Duluth.