Abstract
Purpose :
Risk factors for small choroidal melanocytic lesion growth to melanoma have been redefined using multimodal imaging. We explored provider ability to recognize risk factors for small choroidal melanocytic lesion growth to melanoma before and after image-based education and with and without multimodal imaging.
Methods :
Providers were invited to participate in a survey assessing ability to identify risk factors for small choroidal melanocytic lesion growth to melanoma using either fundus imaging alone or multimodal imaging. Risk factors included thickness >2mm on ultrasonography, subretinal fluid on optical coherence tomography, presence of orange pigment by autofluorescence, acoustic hollowness by ultrasonography, and diameter >5mm by fundus imaging. Performance was assessed before and after participants reviewed an educational PowerPoint providing pictorial examples of risk factors. Comparison between groups was conducted using two-tailed Fisher’s exact test.
Results :
Thirty and 26 providers completed the pre-education and post-education assessments, respectively. Post-education participants were more accurate within ±1 risk factor for lesions with zero risk factors (77% vs. 100%, p=0.01) or two risk factors (79% vs. 91%, p=0.03). Following education, participants presented with multimodal imaging (compared with single fundus images) more often correctly identified lesions with four (12% vs. 42%, p=0.03) or five (4% vs. 39%, p=0.004) risk factors, demonstrated lower mean level of concern for lesions with zero risk factors (2.0 vs. 1.4, p<0.001), and expressed higher level of concern for lesions with 5 risk factors (2.4 vs. 3.6, p<0.001).
Conclusions :
Use of multimodal imaging may be more beneficial than education itself to improve accuracy of risk factor identification for small choroidal melanocytic lesions.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.