Flat Choroidal Nevus Inaccessible to Ultrasound Sonography Evaluated by Enhanced Depth Imaging Optical Coherence Tomography

PURPOSE To demonstrate the usefulness of enhanced depth imaging optical coherence tomography (EDI-OCT) in investigating choroidal lesions inaccessible to ultrasound sonography. METHODS In a 60-year-old woman with an asymptomatic choroidal nevus, normal OCT was used to observe the macula and EDI-OCT to image the choroidal nevus that was inaccessible to ultrasound. The exact location of the lesion in the choroid and the dimensions of the nevus were measured. RESULTS The lesion was located in the superior macula, and the nevus was homogeneous in its reflectivity. We observed a thickened choroid delineated by the shadow cone behind it, measuring 1,376 × 325 μm in the larger vertical cut and 1,220 × 325 μm in the larger horizontal cut in an image with a 1:1 pixel mapping and automatic zoom. The macular profile and thickness were both normal. CONCLUSIONS EDI-OCT appears to be an excellent technique for measuring choroidal nevi and all choroidal lesions accessible to OCT imaging by depicting their exact location in the choroid, their dimensions, and their demarcation from the surrounding healthy tissue, thus allowing for a more efficient and accurate follow-up.