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Conjunctival nevi usually remain stable over years
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Over time, a conjunctival nevus may change color or size, but it tends to remain stable, according to a long-term study.
Carol Shields, MD, and colleagues at Wills Eye Hospital in Philadelphia retrospectively reviewed the charts of 410 patients diagnosed with conjunctival nevi. The two main outcome measures were alterations in tumor size and color.
Of the 410 patients, a majority (89%) were white. Irides were brown in 229 of 418 eyes (55%), blue in 85 (20%), green in 20% and eye color was not indicated in 21 eyes (5%). At baseline, the nevus was brown in 65%, tan in 19% and completely nonpigmented in 16%.
Anatomically, the location of the nevus was the bulbar conjunctiva in 302 eyes (72%), the caruncle in 61 eyes and the plica semilunaris in 44 eyes. Other locations included the fornix, tarsus and cornea. The bulbar conjunctival lesions most commonly abutted the corneoscleral limbus.
Cysts were clinically detected in 70% of the histopathologically confirmed compound nevi, 58% of the subepithelial nevi, 40% of the junctional nevi and in none of the blue nevi.
Of the original patient group, 149 were observed for a mean of 11 years. In these patients, the lesion color grew darker in seven, lighter in 12 and was stable in 130. The lesion grew in 10 patients, appeared smaller in one patient and remained stable in 137 patients. Three patients developed malignant melanoma from an existing compound nevus or blue nevus over a mean of 7 years.
The study is published in the February issue of Archives of Ophthalmology.