Suspicious Nevus – page 13 of 23
Optos Gallery — Typical Nevus Will the lesion show up on both red and green separation?
Suspicious Nevus – page 12 of 23
Separation of the composite color Optos images into red and green channels is helpful in many cases. Subtle findings at the level of the retina (anterior to the retinal pigment epithelium) are most obvious with the green separation view, and subtle findings at the level of the choroid (posterior to the RPE) are most obvious
Suspicious Nevus – page 11 of 23
Optos ResMax™ image depicts drusen on the surface of the lesion—a finding which suggests chronicity. In contrast, the orange pigment, most likely lipofuscin, may suggest recent activity. Hence, both a benign and an ominous finding present simultaneously.
Suspicious Nevus – page 10 of 23
The Optos fly through is particularly helpful in patient education in demonstrating the size and position of lesions and other abnormalities Optos optomap® ultra widefield image
Suspicious Nevus – page 9 of 23
optomap® color fundus image of the left eye demonstrating the size and location of lesion. Only one lesion is observed in this eye and none in the fellow eye.
Suspicious Nevus – page 8 of 23
Topcon 3D OCTFigure A: The 3D representation of the lesions’ elevation is depicted on the left. This image is composed of the 128 horizontal slices within the green box.Figure B: One horizontal slice of the 128 sections contained in the 6x6 mm box is demonstrated below. RPE, depicted in red, is elevated due to the
Suspicious Nevus – page 7 of 23
Left Eye Topcon 3D OCT 2 dimensional movie which is composed of 128 horizontal sections beginning from the top and going down. All sections are contained within the 6 mm x 6 mm green box (see next page). Note: The movie can be paused or replayed by the use of the control
Suspicious Nevus – page 6 of 23
Sections through the drusen (section B below) reveal elevations of the RPE with virtually no PIL observed. The patient has been evaluated every 3 months for the last 2 years without any change. This melanocytic lesion appears to be a nevus but an early melanoma cannot be ruled out and careful monitoring is recommended.
Suspicious Nevus – page 5 of 23
Topcon 3D OCT with a 6x6 mm box encompassing the lesion. The section which corresponds to the position of the horizontal green line is shown below. Although the choroidal mass is not visualized with the OCT, the resultant retinal elevation is clearly visible of the choroidal mass (presumed to be within the yellow rectangle).
Suspicious Nevus – page 4 of 23
B-Scan Ultrasound Arrow denotes the location of the suspicious lesion. Note the increased echo. * B-Scan for Beginners is available at: http://www.lulu.com