Good monitoring is structured medical care, not casual reassurance. The first goal is to establish a reliable baseline: clear photographs and measurements that make future change obvious. This matters because some lesions remain stable for decades, while a minority show activity over time, and the difference is usually detected on serial comparison, not at a single visit. ²
Baseline documentation typically includes:
- Colour photography (fundus or slit-lamp, depending on location)
- Optical coherence tomography (OCT) when there is potential for retinal involvement or subretinal fluid ³
- Ultrasound when thickness or internal reflectivity needs objective measurement
Once baseline findings are recorded, recall intervals should be risk-based. A low-risk choroidal naevus may be reviewed less often after stability is confirmed, while lesions with risk features (for example subretinal fluid, increasing thickness, orange pigment, symptoms, or documented enlargement) usually require closer surveillance or specialist referral. ¹ ²
Patients should leave with a written plan explaining: the diagnosis, what risk features were (or were not) present, when the next scan is due, and what change would trigger escalation.
References
- Pearce E, Simpson ARH, Keane PA, Sagoo MS, Damato B, Heimann H. Survey of ophthalmic imaging use to assess risk of progression of choroidal nevus to melanoma in the United Kingdom. Ophthalmology Retina. 2023;7(5):401-409. doi:10.1016/j.oret.2022.12.010. PMID: 36549472.
- 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.
- 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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