Spontaneous Resolution of a Choroidal Mass: A Case Series

Abstract

Choroidal masses can be of varying etiologies including tumors of benign, primary, and metastatic nature. Herein, we report on 3 cases of well-documented solitary choroidal masses associated with exudative retinal detachments of unclear etiology (despite extensive workup) that resolved spontaneously.

Keywords: Choroidal mass; Inflammation; Metastasis; Spontaneous resolution.

Fig. 1

a Left fundus photo at baseline showing an orange-yellow choroidal mass with poorly defined edges and overlying pigment mottling. The associated subretinal fluid (SRF) involved the fovea. b Note the multiple hyperfluorescent pinpoint leakages in the late phases of the fluorescein angiography. c Ultrasonography image confirming the dome-shaped choroidal mass with heterogeneous composition and medium-to-high internal reflectivity. d Wavy alteration of the retinal pigment epithelium and choroidal infiltration on enhanced depth imaging optical coherence tomography (EDI-OCT). e Left fundus photo 9 months following initial presentation, demonstrating a residual flat, orange choroidal discoloration and absence of SRF. f At the final visit, EDI-OCT confirmed a normal retinal architecture, absence of SRF, and a choroid without alterations.

Fig. 2

a Color fundus photo of the right eye displaying an ill-defined yellow choroidal mass centered at the superior vascular arcade with surrounding subretinal fluid (SRF) that extends to the macula. b Multiple hyperfluorescent pinpoint areas of leakage on fluorescein angiography. c Ultrasonography (USG) revealing a dome-shaped choroidal lesion with medium internal reflectivity and surrounding SRF. d Swept-source optical coherence tomography (SS-OCT) showing SRF and a wavy alteration of the retinal pigment epithelium (RPE). Hyperreflective dots were noted within the superficial choroid and the inner retina. e Color fundus photo 6 weeks following initial presentation with residual retinal folds, ill-defined hypopigmented choroidal elevation, and absence of SRF. f USG confirmed a residual choroidal mass with a normal retinal architecture, and absence of SRF. g SS-OCT performed after 10 months demonstrated resolution of the choroidal mass, although the wavy alteration of the RPE remained.

Fig. 3

a Color fundus photo of the left eye demonstrating an orange choroidal mass near the superotemporal arcade with subretinal fluid (SRF) and retinal folds extending towards the fovea. b Optical coherence tomography (OCT) of the left eye illustrating an irregular choroidal contour with SRF. c Multiple areas of late leakage on fluorescein angiography of the left eye. d Ultrasonography of the left eye showing an elevated, acoustically solid mass with high internal reflectivity. e Complete resolution of SRF on OCT of the left eye 5 weeks after the first injection of bevacizumab; however, the wavy, irregular contour of the retinal pigment epithelium remained. f Color fundus photo of the left eye 15 months after initial presentation with hyperpigmentation, areas of atrophy, and resolution of SRF.