Choroidal Melanoma in a 14-Year-Old Patient With Ocular Melanocytosis

Günduz, Kaan; Shields, Jerry A.; Shields, Carol L.; Eagle, Ralph C.

doi:10.1001/archopht.116.8.1112

Cited by 28 publications

(6 citation statements)

References 14 publications

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“…However, this finding has been noted previously with choroidal melanoma, particularly in young patients. 10,11 We previously published a report describing a 14year-old patient with ultrasonographic and histopathologic posterior scleral bowing at the site of a 4.9-mm thick choroidal melanoma. 9 Cham and Pavlin 11 provided an analysis of 24 young patients (<30 years old) with choroidal melanoma and found posterior scleral bowing on ultrasonography in 14 (58%).…”

Section: Discussionmentioning

confidence: 99%

Posterior Scleral Bowing With Choroidal Nevus on Enhanced-Depth Imaging Optical Coherence Tomography

et al. 2015

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IMPORTANCE Recognition of posterior scleral bowing with choroidal nevus is essential to avoid an underestimation of tumor thickness. OBJECTIVE To describe a particular observation of posterior scleral bowing associated with choroidal nevus on enhanced-depth imaging (EDI) optical coherence tomography (OCT). DESIGN, SETTING, AND PARTICIPANTS Retrospective observational case series at a referral center involving 17 eyes of 17 patients. Patients were seen from June 2013 to July 2014, with all data collected and analyzed from June 2014 to July 2014. INTERVENTIONS Retrospective medical record review and multimodal imaging including fundus photography, autofluorescence, infrared reflectance, ultrasonography, and EDI-OCT. MAIN OUTCOMES AND MEASURES Clinical and imaging characteristics. RESULTS Analysis of 318 consecutive patients with choroidal nevus imaged over a 1-year period revealed that 17 cases (5%) demonstrated the EDI-OCT feature of posterior scleral bowing. Of these 17 cases, the mean patient age was 58 years (median, 58 years; range, 36-75 years) and there were 6 men (35%) and 11 women (65%). The nevus was classified as pigmented (n = 3; 18%), nonpigmented (n = 2; 12%), and mixed pigmentation (n = 12; 71%), and with no surrounding halo (n = 7; 41%). Associated features included overlying drusen (n = 9; 53%), retinal pigment epithelial alterations (n = 9; 53%), subretinal fluid (n = 5; 29%), and orange pigment (n = 3; 18%). The nevus was clinically estimated to be of 4.91-mm basal dimension and measured ultrasonographically at 1.59-mm thickness. By EDI-OCT, the nevus mean thickness was 628 μm (0.63 mm). All cases demonstrated posterior scleral bowing with mean scleral excavation of 398 μm (median, 377 μm; range, 134-739 μm). Underlying the nevus, the scleral thickness was not measurable; however, at the nevus margin, the choroid and sclera appeared normal. Clinical features correlated with posterior scleral bowing included reduced distance to the optic disc (difference, 1.3 mm; 95% CI, −2.95 mm to 5.51 mm; P = .01) and the foveola (difference, 2.14 mm; 95% CI, 0.80 mm to 3.48 mm; P < .001), as well as the presence of surrounding halo (difference, 36%; 95% CI, 16.86% to 59.27%; P < .001). CONCLUSIONS AND RELEVANCE Choroidal nevus can show focal posterior scleral bowing on EDI-OCT in 5% of cases. This finding was related to more posterior location of nevus, less/mixed pigmentation, and surrounding halo. This finding could lead to underestimation of tumor thickness as the tumor bows backward rather than forward.

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Section: Discussionmentioning

confidence: 99%

Posterior Scleral Bowing With Choroidal Nevus on Enhanced-Depth Imaging Optical Coherence Tomography

et al. 2015

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“…The main concern with oculo(dermal) melanocytosis is the risk for development of melanoma, predominantly in the uvea. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Oculo(dermal) melanocytosis is rare in the general population. Cowan and Balistocky 6 reviewed 25 000 patients from an eye clinic at the Philadelphia General Hospital between 1956 and 1960, revealing only 4 cases of melanocytosis.…”

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confidence: 99%

Association of Ocular and Oculodermal Melanocytosis With the Rate of Uveal Melanoma Metastasis

et al. 2013

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IMPORTANCE Ocular/oculodermal (oculo[dermal]) melanocytosis is a congenital periocular pigmentary condition that can lead to the development of uveal melanoma, estimated at 1 in 400 affected patients. In this study, patients with melanocytosis who developed uveal melanoma were found to have double the risk for metastasis compared with those without melanocytosis.OBJECTIVE To determine the relationship of oculo(dermal) melanocytosis to the prognosis of patients with uveal melanoma.

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“…Malignant choroid melanoma is a potential ocular risk in oculodermal melanocytosis in Asian patients. (17,18) Increased numbers of melanocytes in hyperpigmented tissues may be the basis for the development of rnelanoma. (18) The risk gradually increases after the first decade of life and melanoma developing from a choroidal naevus within the area of hyperpigmentation has been described.…”

Section: Discussionmentioning

confidence: 99%

Nevus of Ota: clinical-ophthalmological findings

Cronemberger¹,

Calixto²,

Freitas³

2011

Rev. bras.oftalmol.

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Objective:To analyze the clinical and ophthalmological findings of patients with nevus of Ota. Methods: Retrospective analysis of patients' charts with nevus of Ota. We registered the demographic data, location of the nevus and date of appearance, family history of similar spots, biomicroscopic, gonioscopic, tonometric, ophthalmoscopic and perimetric findings. Results: We included 14 patients, six (43.0%) men and eight (57.0%) women, with a mean age of 21.7±17.5 years. Ten (71%) were mulatto, three (21.4%) white and one (7.1%) black. Twelve (85.7%) patients presented the spots at birth and two in puberty. Nine patients presented conjunctival and episcleral pigmentation in the right eye and five in the left eye. According to Tanino's classification, five (35.7%) nevi were class 1, eight (57.1%) class 2 and one (7.1%) class 3. Heterochromia iridis was found in eight (57.1%) patients. Anisocoria was present in three (21.4%) patients. Five (35.7%) patients presented a suspected glaucomatous cup disc ratio (≥0.7); six (42.9%) presented a cup disc ratio ≤ 0.5 and three (21.4%), no cup disc. We found two curious and remarkable findings: a nevus of Ota on the palate of one patient and other on the optic disc associated with a pigmentary mottling of the fundus in another patient. The pigmentary mottling of the fundus was also seen in four more eyes. Conclusions: The nevus of Ota was frequently present at birth, in mulattos, and classified as Tanino's class 1 and 2. Heterochromia iridis was a common finding. Anisocoria was present in a small percentage of eyes. No patient developed glaucoma or malignancy.

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Choroidal Melanoma in a 14-Year-Old Patient With Ocular Melanocytosis

Cited by 28 publications

References 14 publications

Posterior Scleral Bowing With Choroidal Nevus on Enhanced-Depth Imaging Optical Coherence Tomography

Posterior Scleral Bowing With Choroidal Nevus on Enhanced-Depth Imaging Optical Coherence Tomography

Association of Ocular and Oculodermal Melanocytosis With the Rate of Uveal Melanoma Metastasis

Nevus of Ota: clinical-ophthalmological findings

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