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Close monitoring recommended for small melanocytic lesions
Lane AM.Arch Ophthalmol. 2010;128:996-1000.
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Associated mortality due to indeterminate melanocytic lesions of the choroid is low, a finding that supports the current practice of monitoring such lesions and initiating treatment only when signs of malignant transformation are present, according to a study.
Researchers at the Massachusetts Eye and Ear Infirmary reviewed 1,063 consecutive patients over a period of 20 years, with 256 patients evaluated for choroidal nevus, 334 patients evaluated for indeterminate lesions and 373 patients evaluated for small melanoma.
Associated mortality was identified through active follow-up or through a database registry.
Overall, 15 deaths were associated with ocular melanoma, of which 13 were in the melanoma group and two were in the indeterminate lesion group.
No deaths due to ocular melanoma were identified in the nevus group. Associated mortality was 5% in the melanoma group compared with 1% in the indeterminate lesion group.
“The management of small elevated pigmented lesions of the choroid is controversial in ophthalmology, and the usual practice currently is to withhold intervention until there is documented evidence of tumor activity,” the researchers wrote. “The results of this study revealed low mortality rates in patients with [indeterminate melanocytic] tumors and support the current management practice of close serial examinations without therapeutic intervention until growth is observed.”
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