Choroidal vitiligo masquerading as large choroidal nevus: a report of four cases

Purpose: To describe 4 patients with choroidal vitiligo masquerading as large choroidal nevus.

Design: Retrospective chart review.

Participants: Observational case series of 4 patients.

Methods: Retrospective chart review.

Main outcome measures: Clinical features.

Results: Four patients referred with the diagnosis of large choroidal nevus were found to have unilateral (n = 1) or bilateral (n = 3) extensive patchy choroidal depigmentation classified as choroidal vitiligo. There was no evidence of choroidal nevus, and the pigmented "lesion" proved to be normal choroidal pigment surrounded by a region of pigment absence (vitiligo). There was no evidence of ocular inflammation or related retinal or retinal pigment epithelial changes. The choroidal vitiligo was clinically flat and measured 12 to 24 mm diameter, involving the post-equatorial fundus in all cases. There were no related anterior segment abnormalities. Cutaneous vitiligo was present in all cases. There was no documented progression of the choroidal or cutaneous vitiligo over a maximum 2-year follow-up.

Conclusions: Choroidal vitiligo is an idiopathic benign process that can involve large segments of the posterior choroid, leaving only patches of residual choroidal pigment, simulating, in reverse, a large choroidal nevus.

Financial disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.