scholarly journals What’s in a Name? Large Choroidal Nevus, Small Choroidal Melanoma, or Indeterminate Melanocytic Tumor

2021 ◽  
pp. 1-4
Author(s):  
Arun D. Singh ◽  
Hans E. Grossniklaus
Keyword(s):  
Choroidal Melanoma ◽  
Melanocytic Tumor ◽  
Choroidal Nevus

A Prediction Model to Discriminate Small Choroidal Melanoma from Choroidal Nevus

2021 ◽  
Author(s):  
Emily C. Zabor ◽  
Vishal Raval ◽  
Shiming Luo ◽  
David E. Pelayes ◽  
Arun D. Singh
Keyword(s):  
Prediction Model ◽  
External Validation ◽  
Choroidal Melanoma ◽  
Subretinal Fluid ◽  
Training Data ◽  
Validation Data ◽  
Orange Pigment ◽  
Melanocytic Tumor ◽  
Predicted Probability ◽  
Choroidal Nevus

Objective: To develop a validated machine learning model to diagnose small choroidal melanoma. Design: Cohort study Subjects, Participants, and/or Controls: The training data included 123 patients diagnosed as small choroidal melanocytic tumor (5.0-16.0 mm in largest basal diameter and 1.0 mm to 2.5 mm in height; Collaborative Ocular Melanoma Study criteria). Those diagnosed as melanoma (n=61) had either documented growth or pathologic confirmation. 62 patients with stable lesions classified as choroidal nevus, were used as negative controls. The external validation data set included 240 patients managed at a different tertiary clinic, also with small choroidal melanocytic tumor, observed for malignant growth. Methods: In the training data, lasso logistic regression was used to select variables for inclusion in the final model for the association with melanoma versus choroidal nevus. Internal and external validation were performed to assess model performance. Main Outcome Measures: Predicted probability of small choroidal melanoma Results: Distance to optic disc ≥3mm and drusen were associated with decreased odds of melanoma whereas male versus female sex, increased height, subretinal fluid, and orange pigment were associated with increased odds of choroidal melanoma. The area under the receiver operating characteristic (AUROC) “discrimination value” for this model was 0.880. The top four variables that were most frequently selected for inclusion in the model on internal validation, implying their importance as predictors of melanoma, were subretinal fluid, height, distance to optic disc, and orange pigment. When tested against the validation data, the prediction model could distinguish between choroidal nevus and melanoma with high discrimination of 0.861. The final prediction model was converted into an online calculator to generate predicted probability of melanoma. Conclusions: To minimize diagnostic uncertainty, a machine learning based diagnostic prediction calculator can be readily applied for decision making and counselling patients with small choroidal melanoma.

scholarly journals Diagnostic A-Scan of Choroidal Tumors: Comparison of Quantified Parameters

2019 ◽  
Vol 5 (5) ◽  
pp. 358-368 ◽  
Author(s):  
Nakul Singh ◽  
Yombe Fonkeu ◽  
Brandy H. Lorek ◽  
Arun D. Singh
Keyword(s):  
Clinical Diagnosis ◽  
Choroidal Melanoma ◽  
Choroidal Metastasis ◽  
Choroidal Hemangioma ◽  
Custom Made ◽  
Tissue Sensitivity ◽  
Choroidal Nevus ◽  
The Mean ◽  
Standard Techniques ◽  
Internal Reflectivity

Aim: To compare quantified ultrasonographic A-scan parameters of common choroidal tumors. Methods: Consecutive patients with a clinical diagnosis of choroidal melanoma (n = 100), choroidal nevus (n = 30), choroidal metastasis (n = 10), and circumscribed choroidal hemangioma (n = 10) were included in this study. Ultrasonographic A-scans (8 MHz, 1,550 m/s, tissue sensitivity = 67 dB) were performed by standard techniques. Using a custom made MATLAB® script, four quantifiable A-scan parameters: tumor height (mm), number of internal reflectivity peaks (numerical value), median internal reflectivity (%), and angle κ (°) were obtained for all (n = 150) tumors. Results: The mean number of internal reflectivity peaks for choroidal nevus, choroidal metastasis, and circumscribed choroidal hemangioma was 3.1, 5.1, and 4.0, respectively. The median internal reflectivity for choroidal melanoma varied from 21.5 to 99.5% (mean = 76.4%). The median internal reflectivity was ≥65% in all choroidal nevus (100%), choroidal metastasis (100%), and circumscribed choroidal hemangioma (100%), and majority of the choroidal melanoma (78%). Conclusions: The quantified A-scan patterns of common choroidal tumors were significantly influenced by the tumor height. Other than median internal reflectivity of < 65%, which seems to distinguish choroidal melanoma from other tumors (choroidal nevus, choroidal metastasis, and circumscribed choroidal hemangioma), there were no specific diagnostic patterns.

False positive magnetic resonance imaging of a choroidal nevus simulating choroidal melanoma

1989 ◽  
Vol 13 (4) ◽  
pp. 265-268 ◽  
Author(s):  
Kwan-Rong Liu ◽  
Gholam A. Peyman ◽  
Mahmood F. Mafee ◽  
Dao-Yi Yu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
False Positive ◽  
Choroidal Melanoma ◽  
Resonance Imaging ◽  
Choroidal Nevus

scholarly journals Use of OCT Angiography in Choroidal Melanocytic Tumors

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Juan J. Toledo ◽  
Mónica Asencio-Duran ◽  
Jesús R. García-Martinez ◽  
Alejandro López-Gaona
Keyword(s):  
New Technology ◽  
Choroidal Melanoma ◽  
General Description ◽  
Vascular Networks ◽  
Cross Sectional ◽  
Melanocytic Tumors ◽  
Choroidal Melanomas ◽  
Choroidal Nevus ◽  
Histopathological Studies

Objective. To describe OCTA findings in choroidal melanocytic tumors, especially the microcirculation patterns, and to try to correlate with the histopathological studies. Methods. Cross-sectional, comparative, observational study. 70 cases, including 55 choroidal nevi and 15 choroidal melanomas. Three different observers evaluated specific variables in the choriocapillaris layer on AOCT images and searched for images which described histopathologic vascular patterns, and also, a general description of the images was made. Complementary multi-imaging studies included EDI SD-OCT, color and autofluorescence fundus imaging, Doppler ultrasound, and indocyanine/fluorescein angiography. Main Results. Good quality studies were acquired in 80% of the cases, with kappa indexes 0.768–0.958. Nevus OCTA images were described mainly as hyperreflective (72.7%), whereas choroidal melanoma as iso/hyporeflective (62.5%). Avascular areas were found in 50.96% and in 33.3% of choroidal nevus and choroidal melanomas, respectively. A neovascular membrane was found only in cases of choroidal nevus (16.3%). Only in cases of choroidal melanomas, we found vascular loops (6.6%) or vascular networks (6.6%). Conclusion. OCTA is a promising new technology that can be used to study in vivo the differential characteristics of microcirculations between posterior segment melanocytic lesions. Today, larger studies are needed to corroborate these findings and to correlate it with malignancy.

scholarly journals Bilateral Diffuse Uveal Melanocytic Proliferation Presenting as Small Choroidal Melanoma

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
J. N. Ulrich ◽  
S. Garg ◽  
G. K. Escaravage ◽  
T. M. Meredith
Keyword(s):  
Visual Acuity ◽  
Clinical Picture ◽  
Clinical Case ◽  
Radioactive Iodine ◽  
Palliative Chemotherapy ◽  
Choroidal Melanoma ◽  
Orange Pigment ◽  
History Of ◽  
Choroidal Nevus ◽  
The Right

Purpose. To describe a patient with Bilateral Diffuse Uveal Proliferation who presented initially with a clinical picture consistent with choroidal melanoma.Methods. Presentation of a clinical case with fundus photos, fluorescein angiography, and optical coherence tomography.Results. A 70-year-old Caucasian male with history of esophageal cancer presented with an asymptomatic pigmented choroidal lesion in his left eye initially diagnosed as choroidal nevus. This lesion enlarged over the course of a year and developed orange pigment and increased thickness. A metastatic workup was negative, and a radioactive iodine plaque was placed on the left eye. Over the next six months, the visual acuity in his left eye decreased. His clinical picture was consistent with unilateral Diffuse Uveal Proliferation. A recurrence of his esophageal carcinoma with metastasis was discovered and palliative chemotherapy was initiated. Although his visual acuity improved in the left eye, similar pigmentary changes developed in the right fundus. His visual acuity in both eyes gradually decreased to 20/200 until his death a year later.Conclusion. BDUMP should always be considered in the differential diagnosis of patients with pigmented fundus lesions and a history of nonocular tumors.

scholarly journals Isolated choroidal melanocytosis: clinical update on 37 cases

2020 ◽  
Vol 258 (12) ◽  
pp. 2819-2829
Author(s):  
James J. Augsburger ◽  
Cassandra C. Brooks ◽  
Zelia M. Correa
Keyword(s):  
Choroidal Melanoma ◽  
Initial Diagnosis ◽  
Adult Patients ◽  
Basal Diameter ◽  
Orange Pigment ◽  
Fellow Eye ◽  
Retrospective Clinical Study ◽  
Choroidal Malignant Melanoma ◽  
Choroidal Nevus

Abstract Purpose Isolated choroidal melanocytosis is a congenital melanocytic hyperpigmentation involving the choroid that is not associated with iridic or scleral features of ocular melanocytosis. The purpose of this work was to describe the clinical features and course of a relatively large series of patients with this disorder. Methods A retrospective clinical study of 37 patients with isolated choroidal melanocytosis encountered in a single practice 1986–2018 was done. All lesions were 5 mm or larger in the largest basal diameter, homogeneously melanotic, and completely flat by conventional ocular ultrasonography. Results The 37 patients ranged in age from 2 weeks to 87 years (mean 31.5 years, median 18 years) at initial diagnosis of the melanotic choroidal lesion. Arc length largest basal diameter of the melanotic choroidal lesion ranged from 5.5 to 37 mm (mean 14.6 mm, median 13 mm). The lesion extended beneath the fovea in 18 eyes and to the optic disc margin in 6 eyes. Ten of the lesions straddled the ocular equator, but the center point of all of the lesions was posterior to the equator. The retina was fully attached and appeared normal over the melanotic choroidal lesion in each of these eyes. None of the melanotic choroidal lesions exhibited clumps of orange pigment or drusen on its surface. The lesion was unilateral and unifocal in 36 of the 37 patients. One patient had bilateral choroidal melanocytosis that was isolated in one eye but associated with partial iris melanocytosis in the fellow eye. Three adult patients had a choroidal melanoma localized to the patch of choroidal melanocytosis at baseline. One other adult patient had a choroidal melanoma in the fellow eye at baseline. One pediatric patient had viable unilateral non-familial retinoblastoma in the fellow eye and two adult patients had a classic choroidal nevus in the fellow eye. None of the flat patches of choroidal melanocytosis that were monitored periodically after initial diagnosis expanded appreciably during follow-up ranging from 4.9 months to 15.2 years (mean 5.0 years, median 2.3 years). Conclusions Isolated choroidal melanocytosis is a distinct clinical entity that must be distinguished from broad-based choroidal nevus, choroidal melanocytoma, small choroidal malignant melanoma, acquired bilateral patchy-streaky choroidal melanocytic fundopathy associated with disorders such as cutaneous vitiligo and Waardenburg syndrome, acquired bilateral zonal choroidal melanocytic fundopathy, and diffuse uveal melanocytic proliferation associated with systemic cancer. This disorder appears to predispose affected eyes to development of choroidal melanoma arising from the hypermelanotic patch.

Is optical coherence tomography angiography helpful in the differential diagnosis of choroidal nevus versus melanoma?

2019 ◽  
Vol 30 (4) ◽  
pp. 723-729 ◽  
Author(s):  
Claudia Garcia-Arumi Fuste ◽  
Federico Peralta Iturburu ◽  
Jose Garcia-Arumi
Keyword(s):  
Optical Coherence Tomography ◽  
Differential Diagnosis ◽  
Optical Coherence Tomography Angiography ◽  
Choroidal Melanoma ◽  
Fundus Photography ◽  
Imaging Features ◽  
Optical Coherence ◽  
Vascular Networks ◽  
Choroidal Nevus ◽  
Choroidal Nevi

Purpose: To describe the imaging features of choroidal nevus and melanoma using optical coherence tomography angiography, and evaluate the ability of this technique to establish the differential diagnosis based on the display of the tumor’s intrinsic vasculature. Methods: Comparative analysis of optical coherence tomography angiography findings in consecutive patients diagnosed with choroidal nevus or choroidal melanoma following a complete ophthalmic evaluation, including best-corrected visual acuity and several imaging studies: color fundus photography, B-scan ultrasound, spectral-domain optical coherence tomography, and optical coherence tomography angiography. Optical coherence tomography angiography was used to investigate qualitative differences in the tumor vasculature. Results: Thirty-six eyes (18 cases of choroidal nevus and 18 cases of choroidal melanoma) from 36 consecutive patients were included in the study. Only cases located posterior to equator were included to enable performance of all tests. On optical coherence tomography angiography, choroidal nevus showed well-delimited margins (78%), hyperreflective choroid capillary vasculature (83%), fewer avascular areas (17%), and neovascular membrane in one case (6%). Choroidal melanoma showed imprecise margins (72%), hyporeflective choroidal capillary vasculature (72%), multiple avascular areas (78%), and choroidal vascular changes (e.g. thick vascular networks or vascular loops; 45%). Conclusion: Optical coherence tomography angiography can provide useful information for assessing and differentiating between choroidal nevi and small melanomas. Significant differences between these conditions were found for the pattern of reflectivity, and presence/absence of avascular zones and vascular anomalies, which could be helpful for supporting the diagnosis.

MALIGNANT TRANSFORMATION OF A CHOROIDAL NEVUS IN AN EYE TREATED FOR CHOROIDAL MELANOMA

2017 ◽  
Vol 11 (2) ◽  
pp. 131-133 ◽  
Author(s):  
Ido D. Fabian ◽  
Amit K. Arora ◽  
Victoria M. L. Cohen
Keyword(s):  
Malignant Transformation ◽  
Choroidal Melanoma ◽  
Choroidal Nevus
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