Risk Factors for Growth and Metastasis of Small Choroidal Melanocytic Lesions

Shields, Carol L.; Shields, Jerry A.; Kıratlı, Hayyam; Potter, Patrick De; Cater, Jacqueline

doi:10.1016/s0161-6420(95)30864-0

Cited by 278 publications

(223 citation statements)

References 30 publications

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“…Shields et al 17 found increased tumor thickness (>1 mm), location touching the optic disc, visual symptoms, presence of orange pigment, and subretinal fluid as factors predictive of future growth (Fig 1). The risk of tumor growth is 4% if none of these factors are present and more than 50% if three factors are present.…”

Section: Natural History and Metastasismentioning

confidence: 99%

“…Most recently, the COMS, involving more than 50 centers in the United States and Canada, reported a misdiagnosis rate of 0.48%, the lowest rate ever reported. 16 In a retrospective review of 1,329 small melanocytic choroidal tumors, Shields et al 17 found that documented growth of a lesion carried a 3.2 relative risk of metastasis. They also reported that 18% of identified lesions in the study demonstrated growth in a median time of 25 months, and 3% metastasized in a median time of 51 months.…”

Section: Natural History and Metastasismentioning

confidence: 99%

See 1 more Smart Citation

Choroidal Melanoma: Natural History and Management Options

Bell

Wilson

2004

Cancer Control

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Section: Natural History and Metastasismentioning

confidence: 99%

Section: Natural History and Metastasismentioning

confidence: 99%

Choroidal Melanoma: Natural History and Management Options

Bell

Wilson

2004

Cancer Control

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“…Some earlier studies have failed to show a relationship between the quadrantic location of small choroidal melanocytic lesions and their growth potential. 9,28 However, we presume that our methods for analysing the topography of choroidal naevi provide more accurate data on this topic than those reported previously.…”

Section: Discussionmentioning

confidence: 80%

Topographical distribution of choroidal naevi in the ocular fundus

Krohn

Frøystein

Dahl

2008

Eye

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Objective To analyse the topographical distribution of choroidal naevi and to visualise their location in the ocular fundus. Methods Data on the size and location of 210 choroidal naevi were converted into a database of two-dimensional retinal charts by means of computer-drawing software. The geometric centre of each lesion was entered into corresponding sectors of the retinal chart. The location of the naevi was computationally visualised by merging the fundus drawings and displaying the number of overlapping lesions on colour-coded contour maps. Results Five naevi were located exactly between two fundus sectors, and were therefore excluded from the distribution analysis. Ten naevi (5%) were located anterior and 195 (95%) posterior to the equator. A total of 104 naevi (51%) were located in the temporal and 101 (49%) in the nasal hemisphere, and the distribution between the superior and inferior hemisphere was 104 (51%) and 101 (49%), respectively. The distribution did not differ significantly between genders, age groups, or between right and left eyes. More naevi with a diameter of 43 mm were located in the temporal hemisphere (P ¼ 0.0004) and anterior to the equator (P ¼ 0.006) compared with those with a diameter of p3 mm. A similar distribution was found for naevi with overlying drusen. Conclusions Choroidal naevi are uniformly concentrated in the centre of the posterior pole without any significant nasotemporal or superoinferior asymmetry. However, large naevi occur significantly more often in the temporal hemisphere and more anteriorly compared with small lesions.

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“…The decision to treat choroidal melanocytic lesions depends on the presence of risks for growth, including lipofuscin, subretinal fluid, tumour thickness, proximity to optic nerve, and visual symptoms. 24,25 Most ocular oncologists will treat a choroidal lesion if two or more of these five risk factors for growth are present, as the risk for growth in 5 years is above 50%. 24 Furthermore, documented growth is a risk factor for metastasis.…”

Section: Introductionmentioning

confidence: 99%

“…24 Furthermore, documented growth is a risk factor for metastasis. 25 Under these circumstances, the assessment of lipofuscin becomes a crucial issue. Clinically, the lipofuscin pigment is seen as orangecoloured patches over a pigmented choroidal melanocytic lesion.…”

Section: Introductionmentioning

confidence: 99%

Review of fundus autofluorescence in choroidal melanocytic lesions

Günduz

Pulido

Ezzat

et al. 2008

Eye

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Fundus autofluorescence (FAF) imaging takes advantage of the fluorescent properties of some molecules, especially lipofuscin. FAF derives mainly from retinal pigment epithelium (RPE) and Bruch's membrane. Using confocal scanning laser ophthalmoscope (cSLO) we have previously shown that FAF associated with pigmented choroidal lesions can be attributed to mainly lipofuscin (orange pigment) within the RPE. Other causes of FAF include hyperpigmentation, drusen, or fibrous metaplasia probably because they also cause lipofuscin accumulation in the overlying RPE. There is a total or partial correlation between FAF and the foci of lipofuscin and hyperpigmentation in about 90% of the cases. The FAF patterns of choroidal melanocytic lesions were classified as patchy or diffuse. The patchy pattern was defined as the presence of distinct areas of increased FAF between areas of normal autofluorescence. The diffuse pattern was characterized by the presence of increased FAF with indistinct borders over a larger part (450%) of the tumour in the absence of such intervening areas. Choroidal melanomas presented with either a diffuse or patchy pattern, whereas choroidal naevi demonstrated only the patchy pattern. Diffuse FAF pattern was more often associated with larger choroidal melanomas as well as with early venous and late hyperfluorescence on fluorescein angiography. Limitations of these observations depend on the field of depth of cSLO; thus, FAF from other planes could not be detected. Increased retinal thickness, intraretinal oedema, or presence of subretinal fluid may also affect the FAF signal.

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Risk Factors for Growth and Metastasis of Small Choroidal Melanocytic Lesions

Cited by 278 publications

References 30 publications

Choroidal Melanoma: Natural History and Management Options

Choroidal Melanoma: Natural History and Management Options

Topographical distribution of choroidal naevi in the ocular fundus

Review of fundus autofluorescence in choroidal melanocytic lesions

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