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Maria P. Mera, Manuel F. Bande, Maria Santiago, Maria Pardo, Carmen Capeans, Antonio Pineiro, Maria J. Blanco; Detection and Registration of Risk Factors for Malignant Transformation at the First Consultation of Choroidal Nevi. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3264.
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Seven clinical and ultrasonographic factors have been described to identify those choroidal nevi (CN) with risk of transformation into malignant melanomas: thickness > 2 mm, orange pigment, symptoms, subretinal fluid, margin minor than 3 mm from optic disc, absence of atrophic halo and acoustic hollowness. The aim of this study is to describe our experience assessing and registering the presence of risk factors (RF) for malignant transformation at the first consultation.
104 CN from 103 patients have been consecutively studied at our Unit. A complete ophthalmic and ultrasonographic examination was carried out in all cases. Moreover, an OCT examination was made in all cases to identify the presence of subretinal fluid related to the mass. Retinographs were taken in all cases. Visual symptoms were those directly related with the presence of the choroidal nevi (visual acuity diminution, floaters, photopsia, metamorphopsia). Orange pigment was studied by means of biomicroscopy and retinography. Quantitative standardized ultrasonography was used to find the presence of acoustic hollowness.
74 women and 29 men with a mean age of 61.77 years (SD= 14.668; range: 21-90) were included in this study. 104 eyes were studied (50 right and 54 left). The more frequent RF was absence of atrophic halo, and the less frequent RF was thickness > 2mm. A 34.1% of patients had 1 RF, 27.3% have 2 RF, 15.9% 3 RF, 6.8% 4 RF, 11.4% 5 RF, 2.3% 6 RF and 2.3% 7 RF. However, a 57.7% of patients had more than 2 RF not registered or missed at the first examination.
Nowadays the detection of CN with risk of transformation in malignant melanoma should be exhaustive. The authors think each RF must be adequately searched and registered. In patients with CN, evaluation and progression of their RF could be essential to plan the follow-up and suitable treatment.
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