Abstract
Purpose :
Uveal melanoma (UM) is the most common intraocular malignancy in adults, and there is increasing interest in early detection and intervention to improve patient outcomes (Murray et al. 2021). However, small UM pose a challenge for identification and treatment as they may closely resemble benign choroidal nevi. Lesions that cannot be accurately classified as UM or choroidal nevi have been termed indeterminate melanocytic choroidal tumors (IMCT), and their identification may allow for more conservative management to avoid unnecessary treatment. To better identify the differences between these two lesions, we used multimodal imaging to compare the clinical characteristics associated with UM and IMCT.
Methods :
A retrospective chart review was conducted of patients diagnosed with UM and IMCT at the University of Illinois at Chicago between 02/2014 and 07/2022. Exclusion criteria were patients without all imaging modalities available or poor image quality. Patient demographics were recorded and analyzed alongside lesion thickness and risk factors for malignant transformation using ultra-widefield imaging (Optos PLC, Dunfermline, Fife, Scotland, UK), ultrasonography (Eye Cubed, Ellex Medical, Adelaide, Australia), and optical coherence tomography (Spectralis, Heidelberg, Heidelberg, Germany).
Results :
206 patients met the inclusion criteria. Of the patients reporting race and ethnicity, the majority identified as White (86.9%) and Non-Hispanic or Latino (96.1%). The mean age of presentation was 66 years of age for both groups. UM had significantly greater lesion thickness than IMCT (p < 0.0001) and greater instance of ultrasound hollowness (p = 0.002). There were no significant differences in subretinal fluid, orange pigment, or posterior location.
Conclusions :
Though significant differences were present between groups, UM and IMCT were found to have similar clinical features. These findings demonstrate the challenge of accurately classifying melanocytic choroidal tumors. More methods of evaluation may be necessary to understand the clinical profiles of UM and IMCT in order to improve the diagnosis and management of these conditions.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.