a 16-year - old girl was referred to our clinic with a diagnosis of neuroretinitis or juxtapapillary chorioretinitis . the patient had a 3-week history of decreased vision and metamorphopsia in her left eye . systemic work - up for tuberculosis , sarcoidosis , syphilis , lyme disease , brucellosis , and toxoplasmosis was negative . at our initial visit , best - corrected visual acuity was 20/20 in the right eye and counting fingers in the left eye . fundus examination of the left eye revealed a juxtapapillary , elevated , white chorioretinal lesion consistent with cnv that was associated with exudation and retinal edema [ fig . the juxtapapillary choroidal nevus underlying cnv was not visible with color fundus photography [ fig . 1a ] , but we were able to detect it with the brightest illumination of the indirect ophthalmoscope . fundus fluorescein angiography ( ffa ) demonstrated extrafoveal , juxtapapillary cnv , and late diffuse hyperfluorescence superior to this lesion . optic coherence tomography ( oct ) confirmed cnv with overlying intraretinal cysts and minimal subretinal fluid . after a written informed consent was obtained , three consecutive monthly intravitreal bevacizumab ( 1.25 mg/0.05 ml ) injections were performed . cnv appeared inactive and smaller in size with complete resolution of exudation exposing an underlying choroidal nevus with 6  6  2.6 mm in dimensions [ fig . oct demonstrated gradual resolution of subretinal fluid and intraretinal cysts [ fig . 2 ] . ffa revealed burnt - out fibrotic cnv with late staining and juxtapapillary hypofluorescence due to underlying choroidal nevus [ fig . the lesion was still inactive and final visual acuity was stable throughout 2 years of follow - up . before treatment : ( a ) juxtapapillary , elevated , white chorioretinal lesion with exudation , ( b ) ffa ( early ) reveals faint juxtapapillary hyperfluorescence of cnv and pin - point hyperfluorescent points superior to this lesion , ( c ) ffa ( late ) shows juxtapapillary cnv and diffuse leakage . after treatment : ( d ) complete resolution of exudation exposing the underlying choroidal nevus ( arrows ) , cnv appears inactive and smaller in size , ( e ) ffa reveals burnt - out fibrotic cnv with late staining and ill - defined juxtapapillary hypofluorescence due to underlying choroidal nevus ( arrows ) oct shows gradual regression of cnv and complete resolution of intraretinal edema and subretinal fluid with restoration of the retinal architecture , ( a ) cnv associated with minimal subretinal fluid and intraretinal cystic edema ( initial visit ) , ( b ) after first injection , ( c ) after second injection , and ( d ) after third injection the case presented herein shows the rare association of cnv with a choroidal nevus in a 16-year - old girl . in a young patient with cnv , inherited and acquired conditions such as angioid streaks , high myopia , trauma , choroidal tumors , familial macular dystrophies , and inflammatory retinochoroidopathies the absence of optic disc edema , vitritis , macular star , or optic disc hyperfluorescence on ffa helped us rule out an inflammatory lesion . our case shows that an underlying choroidal nevus may not be readily perceivable as a cause of cnv when there is prominent exudation from the cnv . most of the ophthalmologists would prefer to perform an indocyanine green angiography to detect the underlying pathology in the presence of a cnv in a young patient . however , we were able to detect the underlying choroidal nevus with indirect ophthalmoscopy and managed successfully with intravitreal bevacizumab injections . choroidal nevus - related cnv is a rare entity and may be either extrafoveal or subfoveal . laser photocoagulation can be used in extrafoveal cnv , but it destroys the overlying retina and the pigment epithelium . visually significant scotomas may develop when laser is applied for subfoveal cnv and lesions located in the papillomacular bundle due to irreversible damage to nerve fiber layer . possible thermal injury to underlying retinal and retinal pigment epithelial structures may lead to atrophic changes in larger areas that may threaten the visual acuity . vascular complications including optic nerve ischemia and retinal vessel occlusions were reported in juxtapapillary choroidal hemangiomas managed with photodynamic therapy . considering these potential complications , we preferred intravitreal bevacizumab injection for the management of juxtafoveal cnv which was found to be secondary to a choroidal nevus . we did not observe any adverse event and we achieved both anatomical and functional improvement with this treatment modality . in conclusion , an underlying choroidal nevus should be considered in the differential diagnosis of cnv in young patients . to our knowledge , our patient represents the first case of choroidal nevus - related cnv successfully treated with intravitreal bevacizumab injections .
choroidal nevi are the most common benign pigmented lesions of the fundus . 
 choroidal neovascularization is a rare complication of choroidal nevi . 
 we report herein a young patient managed successfully with intravitreal bevacizumab injections for juxtapapillary choroidal neovascularization secondary to choroidal nevus simulating an inflammatory lesion .