Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

122 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Suggest treatment for nevus on left retina

Answered by
Dr.
Dr. Dadapeer K

Ophthalmologist

Practicing since :2003

Answered : 5709 Questions

default
Posted on Mon, 9 Mar 2015 in Vision and Eye Disorders
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.
doctor
Answered by Dr. Dadapeer K 8 hours later
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
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Dadapeer K 16 hours later
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.
doctor
Answered by Dr. Dadapeer K 9 minutes later
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
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Dadapeer K 29 hours later
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?
doctor
Answered by Dr. Dadapeer K 1 hour later
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
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
default
Follow up: Dr. Dadapeer K 13 hours later
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.
doctor
Answered by Dr. Dadapeer K 18 minutes later
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
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,  
Medical Procedures ,  
Medical Topics ,  

Recent questions on  Fluorescein angiography

doctor1 MD

I have a retina edema issue and my retinologist says it is caused by hypertension . My internist is treating my hypertension, and I am wondering if I should have a specialist consult as the retinologist says the edema is still there and a little...

doctor1 MD

FUNDUS FLUORESCEIN ANGIOGRAM: RE: Normal arm to retinal circulation time. There are two dots of hyperfluorescence within the macula, appareling in the very early phase and not increasing in size and intensity in the late phases suggestive of RPE window defects. the FAZ is distorted.

doctor1 MD

sir, i am girish battabyal.age-24 i have been suffering from reduction of vision in both eyes in 1998. i has been use spectacles for 1 year. last year i visit L V Prasad Eye Instittute in bhubanswar. under follows there report. on examination here his best correct visual acuity was 6/43P (-0.75 Dsph/-0.50 Dcyl @ 180 degree) in right eye and 6/48P (-1.00 Dsph) in left eye. Intraocular pressure was 15 mmHg in both eyes. fundus examination shows areas of retinal pigment epithelial mottling and retinal flecks in either eyes or retinal pigment epithelial atrophy at fovea. cup disc ratio was 0.3:1 in both eyes. fundus fluorescein angiography showed silent choroid in addition to areas of transmission defect. Based on the clinical findings a diagnosis of stargardt s disease in both eyes was made. unfortunately we don t have any treatment for the desease at present. Poor visual prognosis was explained to him. we advise him low vision aids trial. he had undergone low vision aids trial on 21-12-2009.

doctor1 MD

Hi, I was in a car crash which rolled multiple times just over 2 months ago. At the time i had severe bleeding, which covered all of the whites of my eyes. I have been diagnosed with commotio retinae to the right eye. The blurring is quite central...

doctor1 MD

On Nov/06 I had the following procedure performed: Phacoemulsification with posterior chamber intraocular lens , par plana vitrectomy , membrane peel, endolaser, air-fluid exchange, intravitreal Kenalog right eye. Today in a follow-up visit the doctor mentioned when examining my eye that there are 3 cysts and a bit of swalling -- he did not put a lot of enphasis on this and gave me some drops to use 4 times a day. My next appointment is in a month, but now after reading some information on the internet I am confused because cysts in the eye appear to be serious. Do I have reasons to be alarmed? Should I call my retina doctor and ask him to see him sooner than a month? What do you advise? Thanks, ELP

doctor1 MD

hi, my brother in law have this so called VKH and he is taking Medrol 8ml, exopred eyedrops at dolo-neurobion.. he starts medrol in 24 then 16 and now 8ml.. but he's face is getting bigger and we want to reduce it but how?and he's left eye cannot see anything anymore.. now, the other eye is having blurred vision and and he can only see us in black n white.. please help him..