TY - JOUR
T1 - Iris nevus growth into melanoma
T2 - Analysis of 1611 consecutive eyes: The ABCDEF guide
AU - Shields, Carol L.
AU - Kaliki, Swathi
AU - Hutchinson, Anne
AU - Nickerson, Stephanie
AU - Patel, Jinali
AU - Kancherla, Swarupa
AU - Peshtani, Ani
AU - Nakhoda, Shazia
AU - Kocher, Kristen
AU - Kolbus, Emily
AU - Jacobs, Emily
AU - Garoon, Robert
AU - Walker, Brianna
AU - Rogers, Brittany
AU - Shields, Jerry A.
N1 - Funding Information:
Support provided by Eye Tumor Research Foundation, Philadelphia, PA (C.L.S., J.A.S.), Lift for a Cure, Morrisdale, PA (C.L.S., J.A.S.), and the Lucille Wiedman Fund for Pediatric Eye Cancer, Philadelphia, PA (J.A.S., C.L.S.). The funders had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; and in the preparation, review, or approval of the manuscript. Carol L. Shields, MD, has had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
PY - 2013/4
Y1 - 2013/4
N2 - Purpose: To determine clinical features predictive of growth of iris nevus into melanoma. Design: Retrospective, comparative case series. Participants: A total of 1611 consecutive patients referred to an ocular oncology center with iris nevus. Intervention: Observation and photographic documentation. Main Outcome Measures: Growth into melanoma. Results: The mean age at referral for iris nevus was 51 years (median, 54; range, <1-94 years). At presentation, the mean tumor basal diameter was 3 mm (median, 3 mm; range, <1-12 mm) and mean tumor thickness was 0.8 mm (median, 0.5 mm; range, 0-5 mm). All patients were initially diagnosed with benign iris nevus. Growth of iris nevus to melanoma was confirmed in 2% of eyes (n = 27) over a mean follow-up of 68 months (median, 46 months; range, 3-465 months). By Kaplan-Meier estimates, iris nevus growth to melanoma occurred in <1%, 3%, 4%, 8%, and 11% at 1, 5, 10, 15, and 20 years, respectively. Factors predictive of iris nevus growth to melanoma by multivariable analysis included age ≤40 years at presentation (hazard ratio [HR], 3), episode of hyphema (HR, 9), 4:00 to 9:00 clock hour location of tumor (HR, 9), diffuse tumor (involving entire iris surface) (HR, 14), ectropion uveae (HR, 4), and feathery tumor margins (HR, 3). Additional important factors by univariable analysis included tumor seeding on the iris or in the anterior chamber angle, feeder vessels, and nodule formation. These factors can be remembered using the mnemonic ABCDEF, representing A = age young, B = blood, C = clock hour inferior, D = diffuse, E = ectropion, and F = feathery margin. Conclusions: In an analysis of 1611 cases of iris nevus referred for evaluation at an ocular oncology center, growth into melanoma occurred in 8% by 15 years. Risk factors for growth, identified by ABCDEF included Age young, Blood (hyphema), Clock hour inferior, Diffuse configuration, Ectropion uveae, and Feathery tumor margin. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
AB - Purpose: To determine clinical features predictive of growth of iris nevus into melanoma. Design: Retrospective, comparative case series. Participants: A total of 1611 consecutive patients referred to an ocular oncology center with iris nevus. Intervention: Observation and photographic documentation. Main Outcome Measures: Growth into melanoma. Results: The mean age at referral for iris nevus was 51 years (median, 54; range, <1-94 years). At presentation, the mean tumor basal diameter was 3 mm (median, 3 mm; range, <1-12 mm) and mean tumor thickness was 0.8 mm (median, 0.5 mm; range, 0-5 mm). All patients were initially diagnosed with benign iris nevus. Growth of iris nevus to melanoma was confirmed in 2% of eyes (n = 27) over a mean follow-up of 68 months (median, 46 months; range, 3-465 months). By Kaplan-Meier estimates, iris nevus growth to melanoma occurred in <1%, 3%, 4%, 8%, and 11% at 1, 5, 10, 15, and 20 years, respectively. Factors predictive of iris nevus growth to melanoma by multivariable analysis included age ≤40 years at presentation (hazard ratio [HR], 3), episode of hyphema (HR, 9), 4:00 to 9:00 clock hour location of tumor (HR, 9), diffuse tumor (involving entire iris surface) (HR, 14), ectropion uveae (HR, 4), and feathery tumor margins (HR, 3). Additional important factors by univariable analysis included tumor seeding on the iris or in the anterior chamber angle, feeder vessels, and nodule formation. These factors can be remembered using the mnemonic ABCDEF, representing A = age young, B = blood, C = clock hour inferior, D = diffuse, E = ectropion, and F = feathery margin. Conclusions: In an analysis of 1611 cases of iris nevus referred for evaluation at an ocular oncology center, growth into melanoma occurred in 8% by 15 years. Risk factors for growth, identified by ABCDEF included Age young, Blood (hyphema), Clock hour inferior, Diffuse configuration, Ectropion uveae, and Feathery tumor margin. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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U2 - 10.1016/j.ophtha.2012.09.042
DO - 10.1016/j.ophtha.2012.09.042
M3 - Article
C2 - 23290981
AN - SCOPUS:84875752595
SN - 0161-6420
VL - 120
SP - 766
EP - 772
JO - Ophthalmology
JF - Ophthalmology
IS - 4
ER -