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Enlargement of choroidal nevi not shown to be a direct predictor of malignant transformation

Ophthalmology. 2011;118(2):382-388.

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Choroidal nevi, particularly those in younger patients, may enlarge slowly over time without transforming into choroidal melanoma, a study found.

The retrospective observational case series included 278 patients with 284 nevi and specifically excluded all nevi that showed evidence of malignant transformation at any point during at least 7 years of photographic follow-up.

Enlargement occurred in 31% of nevi over a mean follow-up of 15 years. The mean increase in diameter was 1 mm, and the median rate of enlargement was 0.06 mm per year. None of the lesions that increased in size developed new risk factors associated with malignant transformation, underwent treatment or caused metastasis.

Multivariate analysis showed younger patient age to be the only factor predictive of enlargement (P < .001), which occurred in 54% of patients age 40 years or younger, compared with 19% of patients older than 60 years.