| Title | Choroidal nevus transformation into melanoma: analysis of 2514 consecutive cases. | | Author(s) | Shields CL, Furuta M, Berman EL, Zahler JD, Hoberman DM, Dinh DH, Mashayekhi A, Shields JA | | Institution | Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA. carol.shields@shieldsoncology.com | | Source | Arch Ophthalmol 2009 Aug; 127(8):981-7. | | MeSH | Adolescent
Adult
Aged
Aged, 80 and over
Cell Transformation, Neoplastic
Child
Child, Preschool
Choroid Neoplasms
Female
Follow-Up Studies
Humans
Kaplan-Meiers Estimate
Male
Melanoma
Middle Aged
Nevus, Pigmented
Proportional Hazards Models
Retrospective Studies
Risk Factors
Young Adult
| | Abstract | OBJECTIVE: To determine features that are predictive of growth of choroidal nevi into melanoma.
METHODS: This was a retrospective medical record review of 2514 consecutive eyes; Kaplan-Meier estimates and Cox regression analyses were used.
RESULTS: The median tumor basal diameter was 5.0 mm and thickness was 1.5 mm. Nevus growth into melanoma occurred in 2%, 9%, and 13% of eyes at 1, 5, and 10 years, respectively. Factors predictive of growth into melanoma by multivariable analysis included tumor thickness greater than 2 mm (P < .001), subretinal fluid (P = .002), symptoms (P = .002), orange pigment (P < .001), tumor margin within 3 mm of the optic disc (P = .001), ultrasonographic hollowness (P < .001), and halo absence (P = .009). A mnemonic device to recall risk factors of ocular melanoma is "To find small ocular melanoma using helpful hints," representing thickness, fluid, symptoms, orange pigment, margin, ultrasonographic hollowness, and halo absence. The median hazard ratio for those with 1 to 2 risk factors was 3; for 3 or 4 factors, 5; for 5 to 6 factors, 9; and for all 7 factors, 21.
CONCLUSIONS: In an analysis of 2514 choroidal nevi, factors predictive of growth into melanoma included greater thickness, subretinal fluid, symptoms, orange pigment, margin near disc, and 2 new features: ultrasonographic hollowness and absence of halo. | | Language | eng | | Pub Type(s) | Journal Article
Research Support, Non-U.S. Gov't
| | PubMed ID | 19667334 |
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