Things that go bump in the light. The differential diagnosis of posterior uveal melanomas

Rennie, I G

doi:10.1038/sj.eye.6700117

Cited by 15 publications

(22 citation statements)

References 196 publications

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“…1 Melanocytomas of the optic disc typically appear as an elevated dark brown or black lesion, which occupies part or occasionally the entire optic disc. 4 Melanocytomas usually extend over the edage of the optic disc and in about half the cases appear to have an associated contiguous choroidal naevus 12 which is merely an extension of the melanocytoma beneath the juxtapapillary retinal pigment epithelium.…”

Section: Discussionmentioning

confidence: 99%

“…Before this they were considered as peripapillary melanomas invading the optic nerve head. 4 Subsequently Cogan coined the term'' magnocellular nevus " 5 and Reese the term 'benign melanoma' to describe the same lesion. 6 Visual impairment with melanocytomas can occur from simple enlargement of blind spot to severe visual loss.…”

Section: Introductionmentioning

confidence: 99%

“…16 Once the basic pathology of melanocytomas was established, they were considered to have no malignant potential. Subsequent reports have shown that these tumours can, in rare instances, undergo malignant transformation 4 and for this reason periodic observation of such lesions is mandatory.…”

mentioning

confidence: 99%

“…4 Melanocytomas are in fact merely a form of naevus which are characterised clinically by their dark brown or black colouration and histopathlogically by the presence of rather plump, round to oval deeply pigmented cells with small round nuclei which lack significant pleomorphism. 4 Although benign, optic disc melanocytomas may enlarge in size. Joffe etal evaluated 27 cases of optic disc melanocytoma and an increase In size in four (15%) cases.…”

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confidence: 99%

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Large optic disc melanocytoma: A rare entity

2015

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Optic disc melanocytoma is a deeply pigmented variant of benign melanocytic nevus thathas been confused with malignant melanoma. Optic disc melanocytomas are locally invasivebut are not known to undergo transformation into malignant melanoma. We present anunusual case of a melanocytoma of the optic disc that is a coincidental fi nding on routinefundus examination even though the size of the melanocytoma is quiet large around 2.5 DD(3.7 mm) in size (while usually mean tumour diameter is 2 mm only) Follow up should remainthe primary approach in the management of the patients with optic nerve melanocytomasas they are benign, as previously advocated by Zimmerman. DOI: http://dx.doi.org/10.3126/ajms.v6i5.11560 Asian Journal of Medical Sciences Vol.6(5) 2015 78-81

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Large optic disc melanocytoma: A rare entity

2015

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“…The clinical significance of choroidal naevi lies in the difficulties in distinguishing them from small malignant melanomas, and in their potential risk for malignant transformation. [7][8][9] Although many reports on choroidal naevi include some information about their fundus distribution, accurate data on this topic are scarce. The main objectives of this study were to analyse the topographical distribution of choroidal naevi and to present a method for visualising their location in the ocular fundus.…”

Section: Introductionmentioning

confidence: 99%

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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Uveal Melanoma: A Review of the Literature

2018

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Melanomas affecting different components of the uvea occur with differing frequencies and clinical presentations. Uveal melanoma is diagnosed via funduscopic exam and ancillary tests. These lesions may present with visual findings or incidental findings on physical exam. Metastasis occurs in approximately half of all patients with primary uveal melanoma. The liver is the most common site of metastasis. Enucleation was at one time considered the definitive local treatment for primary uveal melanoma, but has been largely replaced by other therapeutic procedures that aim to prevent metastasis while preserving vision. Unfortunately, metastasis of uveal melanoma almost always proves to be fatal. The current treatment of metastatic uveal melanoma is limited by the intrinsic resistance of uveal melanoma to conventional systemic therapies. Advancements in molecular biology have resulted in the identification of a number of promising prognostic and therapeutic targets. Early detection and therapy are important factors in disease survival. It is imperative that the treating physician be familiar with the clinical features of uveal melanoma and distinguish it from mimickers in order to ensure effective and timely treatment.

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Things that go bump in the light. The differential diagnosis of posterior uveal melanomas

Cited by 15 publications

References 196 publications

Large optic disc melanocytoma: A rare entity

Large optic disc melanocytoma: A rare entity

Topographical distribution of choroidal naevi in the ocular fundus

Uveal Melanoma: A Review of the Literature

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