Case Series: Retinal Pigment Epithelial Detachments Over Choroidal Nevi - What Is the Clinical Significance?

Introduction: Retinal pigment epithelial detachment (PED) is an uncommon finding associated with choroidal nevi. In this case series, we describe PED overlying a choroidal nevus in 4 patients and discuss the clinical significance of this diagnosis.

Case presentations: Four adult patients diagnosed with unilateral choroidal nevi with associated overlying PEDs were followed over time. Two patients were referred for evaluation due to concerns about potential growth. Fundus photography, B-scan ultrasonography, and optical coherence tomography were performed in all cases. None of the patients developed visual symptoms attributable to the choroidal nevus or PED. No progression or malignant transformation was observed during follow-up.

Conclusion: While PED does not appear to increase the risk of progression to melanoma, it may complicate the evaluation of the underlying choroidal nevus and could lead to decreased visual acuity. Therefore, choroidal nevi with overlying PED should be monitored over time, with particular attention to the potential development of secondary choroidal neovascularization.