Abstract
Purpose :
Using multimodal imaging, literature proposed the following risk factors for choroidal nevus growth into melanoma: increased tumor thickness, subretinal fluid, decreased visual acuity, presence of orange pigment, ultrasound acoustic hollowness, and increased tumor diameter. This study investigated the presence of mentioned risk factors in choroidal nevi, choroidal melanomas, and indeterminate choroidal melanocytic lesions.
Methods :
This retrospective, single-center chart review assessed choroidal melanocytic tumors with multimodal imaging. We defined our primary outcome as the cumulative presence of mentioned risk factors. Further, we evaluated various optical coherence tomography (OCT), ultrasound, and autofluorescence findings. Finally, we examined the electronic charts for any tumor-targeted therapeutic actions and tumor-related complications such as secondary choroidal neovascularization, accompanying retinal detachment, toxic tumor syndrome, or any form of metastases.
Results :
We analyzed 51 tumors from 49 patients during the period from April 2008 to June 2021. Reviewing the diagnoses made in our archived consultation reports, we found 58.8% (30 of 51) choroidal nevi, 23.5% (12 of 51) choroidal melanomas, and 17.6% (9 of 51) indeterminate choroidal melanocytic lesions. During the entire observation period, no choroidal nevus and no indeterminate choroidal melanocytic lesion transformed into a choroidal melanoma. The median (IQR) age was 64.0 (56.0 to 70.5) years, with 23 of 49 (46.9%) patients being female. The follow-up time for all tumors was median (IQR) 25.0 (12.0 to 39.0) months. The choroidal nevi had a median (range) risk score of 0.0 (0.0 to 3.0), and the choroidal melanoma of 5.0 (3.0 to 6.0), with statistically significant different ratings (p < 0.001). Figure 1 shows an example tumor of an indeterminate choroidal melanocytic lesion with two risk factors present.
Conclusions :
Multimodal imaging with fundus photography, OCT, autofluorescence, and ultrasonography, along with visual acuity assessment, creates a score that may help to distinguish choroidal nevi from melanomas objectively. Future studies should re-evaluate the above risk score using a larger study population.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.