June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
MANAGEMENT OF SUSPICIOUS MELANOCYTIC LESIONS OF THE IRIS
Author Affiliations & Notes
  • Monica Oxenreiter
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Anne Marie Lane
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Ivana K Kim
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Evangelos S Gragoudas
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Monica Oxenreiter, None; Anne Lane, None; Ivana Kim, None; Evangelos Gragoudas, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4419. doi:
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      Monica Oxenreiter, Anne Marie Lane, Ivana K Kim, Evangelos S Gragoudas; MANAGEMENT OF SUSPICIOUS MELANOCYTIC LESIONS OF THE IRIS. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4419.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the natural history of indeterminate pigmented lesions of the iris.

Methods : We identified 260 patients evaluated at the Massachusetts Eye and Ear Infirmary for suspicious iris lesions between January 2009 and October 2015, and calculated rates of malignant transformation and metastasis. Melanoma-related mortality in these patients was compared to a group of patients diagnosed with iris or iridociliary melanomas originating in the iris (N=23) during the same period.

Results : Overall, median follow up was 5.7 years. Median VA at last follow-up was 20/25. Mean lesion height was 0.91 mm (range: 0-3.5) for patients with suspicious lesions and 3.46 mm (range: 1.2-6.5mm) for patients with melanomas. Thirteen (5.0%) lesions underwent malignant transformation; mean time from presentation to diagnosis was 76.4 months. These patients were treated with proton therapy with a light-field technique, and three (23.1%) developed complications (secondary glaucoma and NVG in one patient, rubeosis in the second patient, and rubeosis and NVG in the third). One patient (0.38%), followed for 98.4 months before being diagnosed with melanoma, developed metastasis 31.7 months after receiving proton therapy, and died of melanoma 1.5 months after metastasis diagnosis. Ten patients (43.5%) initially diagnosed with melanoma developed complications, including rubeosis (n=5), NVG (n=3), and secondary glaucoma (n=5). Four patients (17.4%) in the melanoma group died from malignant melanoma; time from treatment to metastasis was 26.8 months and time from metastasis to death was 1.3 months.

Conclusions : These data provide evidence that indeterminate melanocytic iris lesions have low malignant potential and that current conservative methods of follow-up are reasonable.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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