Large turbid retinal pigment epithelial detachment camouflaging an underlying choroidal nevus.
OBJECTIVE
To report an unusual large turbid detachment of the retinal pigment epithelium (RPE) overlying a hidden choroidal nevus.


METHODS
Case report.


RESULTS
A 51-year-old woman was referred with an asymptomatic yellow subretinal mass in the left eye presumed to represent a choroidal metastasis or melanoma. Visual acuity was 20/20 in both eyes. Ophthalmoscopy of the left eye revealed a well defined, abruptly elevated, dome-shaped amelanotic lesion temporal to the macular area measuring 4 mm in basal dimension and 2.2 mm in thickness. There was no evidence of drusen, inflammation, or hemorrhage. Fluorescein angiography and optical coherence tomography suggested RPE detachment from unknown cause. After 6 years follow-up, the RPE detachment resolved, exposing an underlying chronic choroidal nevus as the etiology.


CONCLUSIONS
Choroidal nevus can produce an overlying RPE detachment that completely obscures the underlying lesion.
From the Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania. Dr. Perez is a fellow on the Oncology Service and will be in practice at Asociacion Para Evitar la Ceguera Hospital, Mexico City, Mexico.
Benjamin
B
Perez
Carol L
CL
Shields
Jerry A
JA
Shields