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Suggest Treatment For Nevus On Left Retina
Question: Nine years ago an optometrist found a nevus on my left retina and two years ago it began leaking fluid. Edema invaded my macula causing wavy vision. Edema advanced (from nasal side—my point of view) and retreated a few times. I could easily see how advanced by looking at a plain background and blinking. This has corresponded to images taken by my optical oncologist. The last time it advanced a scotoma appeared. It is clear (not black) and absolute. The temporal boarder of the scotoma matches exactly the last farthest extent of the edema. The edema has retreated (based on fluorescein angiography and OCT) and the scotoma remains. No images taken by the doctor reflect the scotoma. It is C-shaped (correct C, not backwards), bent around the fovea, extending 2-5 lines on the amsler grid. The optical oncologist says it has to be a result of the edema and I agree. He says he has never heard of anything like it. Days of internet research, mostly professional articles, revealed no explanation. There are many scotomas that match mine (crescent-shaped) but they are associated with brain tumors, glaucoma, retinitis pigmentosa, or other pathologies, never edema resulting from nevi.
I am 53 years old, male, healthy, with no family history of cancer or any eye disease. I wear contact lenses for myopia. Besides myopia, my right eye is perfectly healthy.
The nevus has not grown since its discovery and is not large enough to warrant immediate treatment for melanoma. This eye might be radiated someday, but it might not, and I want to know if this scotoma can be treated. In the affected eye I have 20/40 vision (with lens) in an area about the size of a dime held at arm’s length, surrounded on three sides by the scotoma (through which I am completely blind). Peripheral vision outside the scotoma is good. The scotoma has been with me about seven months.
Thank you very much.
I am 53 years old, male, healthy, with no family history of cancer or any eye disease. I wear contact lenses for myopia. Besides myopia, my right eye is perfectly healthy.
The nevus has not grown since its discovery and is not large enough to warrant immediate treatment for melanoma. This eye might be radiated someday, but it might not, and I want to know if this scotoma can be treated. In the affected eye I have 20/40 vision (with lens) in an area about the size of a dime held at arm’s length, surrounded on three sides by the scotoma (through which I am completely blind). Peripheral vision outside the scotoma is good. The scotoma has been with me about seven months.
Thank you very much.
Brief Answer:
The scotoma cannot be treated.
Detailed Answer:
Hello
Welcome to Health care magic
I am Dr. DADAPEER K, an Ophthalmologist and I answer health problems related to eye.
I reviewed your history.
I appreciate your research into the topic of choroidal nevus and melanoma.
The scotoma caused by the nevus cannot be treated.
The scotoma is caused by damage to the retina caused by edema. But the further progression of this damage to the retina and further spread of scotoma can be prevented.
The treatment options for your scotoma are regular follow up to assess its growth and spread. If it is showing increase in size with deterioration of vision, treatment by laser or radiation is required.
Hence I advice you to be with regular follow up with your ophthalmologist.
Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.
Thank you
The scotoma cannot be treated.
Detailed Answer:
Hello
Welcome to Health care magic
I am Dr. DADAPEER K, an Ophthalmologist and I answer health problems related to eye.
I reviewed your history.
I appreciate your research into the topic of choroidal nevus and melanoma.
The scotoma caused by the nevus cannot be treated.
The scotoma is caused by damage to the retina caused by edema. But the further progression of this damage to the retina and further spread of scotoma can be prevented.
The treatment options for your scotoma are regular follow up to assess its growth and spread. If it is showing increase in size with deterioration of vision, treatment by laser or radiation is required.
Hence I advice you to be with regular follow up with your ophthalmologist.
Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.
Thank you
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr. Dadapeer. Is the scotoma permanent? Scotomas from some other causes eventually go away. About a year and a half ago I had a scotoma of the same magnitude but in a different place and of a different shape that went away in six days.
Brief Answer:
This scotoma will decrease in size.
Detailed Answer:
Hello
Thank you for the follow up question.
Since the scotoma in your case is caused by edema this will decrease slowly as the edema decreases.
Hence you need to follow it up regularly.
Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.
Thank you
This scotoma will decrease in size.
Detailed Answer:
Hello
Thank you for the follow up question.
Since the scotoma in your case is caused by edema this will decrease slowly as the edema decreases.
Hence you need to follow it up regularly.
Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.
Thank you
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My December 8, 2014, angiography and OCT tests showed the edema had retreated from the macula. So the scotoma was caused by edema, but is not being maintained by edema. So it’s had over two months to decrease in size and has not begun to do so. Is this a bad sign? Does it usually take longer?
Brief Answer:
This will resolve no need to be worried.
Detailed Answer:
Hello
Thank you for the follow up question.
Scotomas usually take time before they resolve completely.
But no need to be worried until unless there is scar they will resolve partially or completely.
Since you does not seem to be having scar no need to be worried.
This will take time but resolve.
Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.
Thank you
This will resolve no need to be worried.
Detailed Answer:
Hello
Thank you for the follow up question.
Scotomas usually take time before they resolve completely.
But no need to be worried until unless there is scar they will resolve partially or completely.
Since you does not seem to be having scar no need to be worried.
This will take time but resolve.
Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.
Thank you
Above answer was peer-reviewed by :
Dr. Yogesh D
You mentioned it doesn’t seem I have a scar. How do you know if there is a scar? Will that show on fundus photography, angiography, OCT, or ultrasound? What is the likelihood of edema leaving a scar?
Thanks again.
Thanks again.
Brief Answer:
Edema will not cause scar.
Detailed Answer:
Hello
Thank you for the follow up.
Scar usually results from inflammation of retina.
Edema will not cause scar.
Scar can be made out by fundus photograph.
Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.
Thank you
Edema will not cause scar.
Detailed Answer:
Hello
Thank you for the follow up.
Scar usually results from inflammation of retina.
Edema will not cause scar.
Scar can be made out by fundus photograph.
Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.
Thank you
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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