Choroidal hypopigmented lesions (CHLs) represent significant diagnostic and therapeutic challenges due to their diverse and complex etiologies, including neoplastic, infectious, and inflammatory origins. Accurately differentiating between benign lesions with good prognoses and malignant or life-threatening conditions is crucial in directing the appropriate management and avoiding unnecessary invasive interventions. We integrate the latest research and clinical guidelines on advanced multimodal imaging modalities, emphasizing their comparative diagnostic value across varied etiologies of CHLs. In contrast to prior studies, this review comprehensively evaluates the clinical implications of these techniques in accurately differentiating between benign from malignant choroidal lesions.
Emphasis is placed on the role of advanced imaging modalities, including swept-source optical coherence tomography, B-scan ultrasound, fundus autofluorescence, fluorescein angiography, and indocyanine green angiography, in enhancing diagnostic precision. These technologies have substantially increased the capability to distinguish between lesion types, improving diagnostic accuracy and giving more targeted therapeutic strategies.
