CAVITARY CHOROIDAL NEVUS SHOWING THICKNESS FLUCTUATIONS IN RESPONSE TO ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR DIABETIC MACULAR EDEMA: A CASE REPORT.

Purpose: The purpose of this study was to report the multimodal imaging features of a cavitary choroidal nevus showing thickness fluctuations that mirrored the response of diabetic macular edema (DME) to intravitreal antivascular endothelial growth factor (VEGF) therapy.
Methods: This is a retrospective case report. Multimodal imaging findings including fundus photography, optical coherence tomography (OCT), fluorescein and indocyanine green angiography, OCT-angiography (OCTA), and B-scan ultrasonography were analyzed.
Results: A woman in her 80s with a cavitary choroidal nevus and DME was treated with intravitreal anti-VEGF therapy using a pro re nata regimen over 5 years. The choroidal nevus showed thickness fluctuations paralleling the response of DME to anti-VEGF therapy. Worsening of the DME was associated with marked increased choroidal lesion thickness on OCT. Conversely, resolution of DME after intravitreal anti-VEGF injections was followed by choroidal lesion flattening on OCT. Variations of the choroidal lesion thickness were mainly dependent on changes of intralesional hyporeflective caverns on OCT.
Conclusion: Our report shows thickness variations of a cavitary choroidal nevus that paralleled the clinical course of DME treated with intravitreal anti-VEGF therapy. To the best of our knowledge, this is the first report on volume variations of a cavitary choroidal nevus after anti-VEGF therapy.
Competing Interests: Dr. J.B. has no financial disclosures. Dr. J.N. has no financial disclosures. Dr. P.R. has no financial disclosures. Dr. B.F. is a consultant for Heidelberg Engineering, Zeiss, Genentech, Bayer, Novartis, and Allergan. He receives research support from Genentech/Roche. The authors declare that there is no conflict of interest regarding the publication of this article.