Parts A, B, F, and H courtesy of Alison Skalet, MD, PhD; parts C– E and G courtesy of Tero Kivelä, MD
Choroidal nevi, clinical appearance. Choroidal nevi are generally thinner than 2 mm and variably brown. They may be solitary (A) or multiple (B). Nevi may demonstrate drusen on their surface (A, arrow). C, Small nevi lack retinal pigment epithelial (RPE) changes. D, Large nevi usually exhibit RPE changes (note the drusen [arrow] and focal RPE hyperplasia [arrowhead] ). E– F, Some nevi display surface lipofuscin, which appears as orange pigment on dark tumors (E, arrows), and pigmented melanolipofuscin on amelanotic tumors (F, arrows) and can be associated with subretinal fluid (E, asterisk). G, Congenital ocular melanocytosis has a diffuse nevus-like dark choroidal appearance. H, Appearance of patchy gray sclera (asterisks) and diffuse iris pigmentation associated with ocular melanocytosis. All of the lesions illustrated in this figure were followed for several years without evidence of growth.