Choroidal nevus transformation to malignant melanoma

A 63-year-old white male presented in 1986 for a routine eye exam. He was without visual complaints. A slightly elevated choroidal nevus was discovered in his left eye superior to and contiguous with the optic nerve. All other findings were unremarkable. Follow-up visits over the next 4 years included photo documentation and did not reveal any growth of the nevus. In 1990, the lesion appeared to increase in elevation and size. Visual acuity was reduced secondary to an overlying serous detachment. The detachment was confirmed on fluorescein angiography. Subsequent follow-up revealed continued growth until an enucleation was performed. This case documents the rare transformation of a benign choroidal nevus into a malignant choroidal melanoma. It also illustrates the importance of fluorescein angiography and ultrasonography, in addition to fundus photography, in the management and follow-up of certain choroidal nevi.