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| |  Certain Clinical, Ultrasonographic Characteristics Can Assist in Diagnosing Uveal Melanoma: Presented at COS By Louise Gagnon TORONTO -- June 24, 2009 -- The presence of certain clinical and ultrasonographic characteristics of uveal nevi and the ability of some nevi to become malignant suggest that ophthalmologists should pay closer attention to their patients who present with uveal lesions, according to a retrospective study presented here at the 72nd Annual Meeting and Exhibition of the Canadian Ophthalmological Society (COS). Uveal nevi that occur in the uveal tract can progress to melanomas, and intervention can stop that potentially lethal progression, said Hamesh Almarzouki, McGill University, Montreal, Quebec on June 22. “You don’t want to wait until the tumour grows,” cautions Dr. Almarzouki. “If melanoma is present, there is a poor prognosis.” Numerous characteristics increase the risk of a uveal nevi progression to melanoma, noted Dr. Almarzouki, adding that several published studies have indicated increasing thickness, the presence of subretinal fluid, orange pigment, and drusen. “Ophthalmologists need to look carefully at the lesion,” said Dr. Almarzouki. The researchers evaluated 65 eyes of 64 patients with uveal nevi who had been examined at McGill University Health Centre hospitals between 1992 and 2008. Data were collected on race, age, sex, colour of the iris, location of the lesion, and findings on ultrasound. Mean age of the patients (61% women) was 66.2 years. The mean follow-up was 50 months. The researchers also recorded characteristics such as drusen, orange pigmentation, and the presence of subretinal fluids. They also noted whether patients had any conditions such as posterior vitreous detachment, age-related macular degeneration, glaucoma, and diabetic retinopathy. The incidence of nevi in patients with light irises was more frequent (78%) than in patients with dark irises (22%). The most common location within the uveal tract of a uveal lesion was the choroids (74%), followed by the iris (23%) and the ciliary body (3%). A small percentage of choroidal nevi are associated with clinical features that increase the likelihood of progression to malignancy. The researchers noted that increasing thickness of uveal nevi was associated with older age. The use of diagnostic ultrasound revealed nonelevated flat lesions in 63% of patients and a nevus >1 mm in 37% of patients. Choroidal nevi with a thickness of >=2 mm were only present in patients aged 60 and older, as was the presence of drusen. These findings are consistent with previously published research. The study found drusen, subretinal fluid, and orange pigment in 22%, 3%, and 2% of patients, respectively. “Ophthalmologists need to react to what they see and closely follow their patients and provide treatment if the lesion looks suspicious,” concluded Dr. Almarzouki. [Presentation title: The Frequency of Important Clinical and Ultrasonographic Features of Uveal Nevi. Abstract P22)
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