How Often Should a Choroidal Naevus Be Checked? Follow-Up Intervals and Imaging Plans

Follow-up for a choroidal naevus should be risk-based, not one-size-fits-all. A small, flat lesion with no symptoms and no high-risk imaging features is often monitored less frequently after stability is confirmed. ¹ In contrast, naevi with one or more risk factors (for example thickness approaching/over 2 mm, subretinal fluid, orange pigment, suspicious ultrasound features, or documented change) are typically reviewed more frequently and may need ocular oncology input. ²

What makes follow-up meaningful is repeatable imaging:

• Colour fundus photography to compare size/shape over time
• Optical coherence tomography (OCT) to detect subtle subretinal fluid and retinal disruption ³
• Ultrasound when thickness/internal reflectivity needs objective measurement

This is why monitoring should produce a clear written plan: baseline measurements, which tests will be repeated, the recall interval, and what change triggers escalation. Patients should not be left with “come back if worried” as the only strategy. ¹ ²

References

1. Chien JL, Sioufi K, Surakiatchanukul T, Shields JA, Shields CL. Choroidal nevus: a review of prevalence, features, genetics, risks, and outcomes. Current Opinion in Ophthalmology. 2017;28(3):228-237. doi:10.1097/ICU.0000000000000361. PMID: 28141766.
2. Shields CL, Furuta M, Berman EL, Zahler JD, Hoberman DM, Dinh DH, et al. Choroidal nevus transformation into melanoma: analysis of 2514 consecutive cases. Archives of Ophthalmology. 2009;127(8):981-987. doi:10.1001/archophthalmol.2009.151. PMID: 19667334.
3. Shields CL, Mashayekhi A, Materin MA, Luo CK, Marr BP, Demirci H, et al. Optical coherence tomography of choroidal nevus in 120 patients. Retina. 2005;25(3):243-252. doi:10.1097/00006982-200504000-00001. PMID: 15805899.

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