Should Choroidal Nevus be Monitored?
February 28, 2010
A whopping 18% of these benign lesions, greater than 10mm, progress to melanoma! Who knew. Despite benign features, these nevi are much more prone to progress to melanoma and need to be monitored.
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Comments
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This sounds like common sense to me. All large choroidal nevi should be monitored. I am surprised that this is a surprise to you.
Also, are you referencing a study, doing a retrospective review of your own charts, or just making numbers up?
I didn’t know that nevi diameter was a predictor of development into melanoma. I think that you can assume a nevus does not start at 10mm in diameter without being noticed in a previous ophthalmological exam. I would think if you performed a retrospective study of your large nevi patients and found that these patient started with a less-than 10mm nevi, the findings would be significant and could be included in a study.
As for the 18%, what study are you citing?
To my knowledge, COMS indicates the following as predictors of melanoma are:
1. Thickness > 2mm
2. Subretinal Fluid
3. Symptoms
4. Orange Pigment
5. Margins within 2 DD or ONH
6. Ultrasonograhpy to examine reflectance and hollowness
7. and the absence of a halo.
I’m pretty sure the likes of Carol and Jerry Shields looked at nevi diameter, but felt that without previous records of nevi size, there is no “proof” that they can be growing.
what was a surprise was that the conversion rate was 18%- that was much higher than i had expected. of course all nevi should be monitored.
the article was in feb’s ophthalmology.
dr. lew- you make a perfectly valid point. the article was in feb’s blue journal (ophthalmology).