Suspicious naevi: observe

Summary Differential diagnosis of large choroidal nevi and small choroidal melanomas may be challenging. The diagnostic approach is guided by various clinical criteria including tumor thickness, presence or absence of subretinal fluid, orange pigment, presence or absence of symptoms, presence or absence of drusen and pin points. In case of doubt, a periodical observation can confirm the correct diagnosis. Taking in account that an irradiation treatment of tumors located close to the macula or the optic disk can produce major irradiation induced complications and visual loss, a carefull periodic observation in selected cases appears as the best diagnostic option.