Features of choroidal naevi on swept source optical coherence tomography angiography and structural reverse flow optical coherence tomography

  • Zaria C. Ali
  • Jane Gray
  • Konstantinos BalaskasEmail author



The purpose of our study was to describe features of choroidal naevi as seen on swept source optical coherence tomography angiography (OCTA) and also on en face images derived from structural data from OCTA.


A prospective observational cohort study was carried out. Patients attending a specialised choroidal naevomelanocytic with known naevi were imaged with swept source OCTA.


Seventy-one eyes of 70 patients were imaged. Forty-three patients and 44 eyes were included. Mean age was 57.7 years (SD 14.9), range 29–81 years. Male to female ratio was 20:23. On OCTA after manual segmentation, naevi could be seen in 47.6% of cases, whereas in the en face images, naevi could be clearly visualised in 79.5% of cases. In OCTA, the superficial and deep capillary plexuses appeared undisturbed as did the outer retinal layer appeared in all cases of flat naevi. In choroidal naevi with mild elevation, the outer retinal layer appeared more susceptible to projection artefacts from overlying retinal vasculature. The choriocapillaris layer showed a fading of the normal homogenous vascular mosaic corresponding to the area of the naevus. In the en face images, even the faintest and thinnest naevi could be visualised in striking detail, and naevi greater than 120 μm thickness appeared darker (p = 0.0034).


OCTA presents characteristic changes in the choriocapillaris layers in cases of choroidal naevi. The association of naevus substance appearing darker with increasing thickness may offer a novel prognostic clue. En face structural OCT may allow accurate, detailed measurement of lateral dimensions which could be of value in the monitoring of suspicious naevi.


Choroidal naevus Optical coherence tomography angiography Imaging Reverse flow Oncology 


Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Zaria C. Ali
    • 1
  • Jane Gray
    • 1
  • Konstantinos Balaskas
    • 2
    • 3
    Email author
  1. 1.Manchester Royal Eye HospitalManchester University NHS Foundation TrustManchesterUK
  2. 2.NIHR Biomedical Research CentreMoorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondonUK
  3. 3.School of Biological SciencesUniversity of ManchesterManchesterUK

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