Serous pigment epithelial defects are often an incidental finding during a retinal exam, but clinicians should take notice, since they may point to choroidal neovascularization, researchers from the Jules Stein Eye Institute report.             

Their study, presented at the 2019 ARVO meeting, enrolled 360 eyes with choroidal nevi, including 19 eyes associated with serous pigment epithelial defects, detected with OCT.

The study reported nine of those 19 eyes (47%) had no change in OCT imaging over the approximate three-year follow-up. In three of the 19 eyes (16%), serous pigment epithelial defects overlying choroidal nevi were associated with choroidal neovascularization. These patients were treated with anti-VEGF therapy (one prior to evaluation and two during routine follow-up).

The study also found one of the 19 eyes developed associated subretinal fluid and orange pigment that was subsequently treated with plaque radiotherapy for presumed malignant transformation.

An additional four eyes with serous pigment epithelial defects had associated subretinal fluid without shaggy photoreceptors or obvious orange pigment and were stable without signs of progression to choroidal malignant melanoma by B-scan ultrasound and fundus photos.

Serous pigment epithelial defects are a rare finding associated with choroidal nevi and can often be mistaken for subretinal fluid during a clinical exam, but it is rarely a sign of malignancy, researchers added.

Hou KK, Soberón V, McCannel TA. Serous pigment epithelial detachments associated with choroidal nevi. ARVO 2019. Abstract 724 - B0202.