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RH Muni, HD McGowan, R Simpson; Prevalence of Various Surface Changes on Presentation in Small and Medium Sized Choroidal Nevi and Melanomas . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1145.
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Purpose:This was a retrospective study to determine the prevalence of various surface changes on presentation, that were identified on the colour fundus photographs of small and medium sized choroidal melanomas and nevi. Methods:Fundus photographs were evaluated of all patients(n=142) that presented to the ocular oncology clinic at the Princess Margaret Hospital, over a three year period, which were diagnosed with either small or medium choroidal melanoma or nevus after the initial consultation. Fundus photographs were examined to determine location of the lesion, degree of foveal or optic nerve involvement, and the presence of various surface changes associated with the lesion. 15 surface changes were evaluated for including drusen, lipofuscin, subretinal fluid, and hemorrhage. Results:More than 50% of small and medium sized choroidal lesions presented with RPE pigmentation(50%, 95CI=41.0-59.0%), RPE metaplasia(66.4%, 95%CI=57.5-74.5%) and drusen(71.9%, 95%CI=63.3-79.5%). Lipofuscin and sub-retinal fluid were present in 39.8%(95%CI=31.3-48.9%) and 33.6%(95%CI=25.5-42.5%) of choroidal lesions respectively. Chi-square tests determined that there were statistically significant differences between small and medium sized choroidal lesions for the presence of hemorrhage(P=0.01), ILM folds(P=0.01), and breaks in Bruch's membrane(P=0.01). Conclusion:This study allowed us to gain a better understanding of the prevalence of various surface changes in small and medium sized choroidal melanomas and nevi. RPE pigmentation, RPE metaplasia and drusen are found in the majority of choroidal lesions on presentation. Hemorrhage, ILM folds and breaks in Bruch's membrane are found more frequently in medium sized lesions.
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