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Differentiate nevus from melanoma
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NEW YORK – When imaging the posterior pole of the eye, it is crucial to distinguish between a choroidal nevus and a small melanoma, according to a presentation Saturday at the PRIMARY CARE OPTOMETRY NEWS symposium held here.
According to Jerome Sherman, OD, a small melanoma may be easily mistaken for a choroidal nevus when viewing the fundus on an Optomap.
“The first time you see a nevus, you should automatically consider the possibility that it is a melanoma, and do another exam at 3 months,” he said. “Then do another exam at 6 months, looking for any change. You need to follow it closely over time.”
Dr. Sherman also recommended using a B-Scan for making a differential diagnosis between a melanoma and a nevus. “A B-Scan is a very underused, but very helpful technology,” he said. “A nevus is barely detectable on a B-Scan, but a melanoma is detectable.”
An emerging new approach to the treatment of AMD is currently being developed. Micro Current Stimulation (MCS) is similar to a pacemaker, keeping photoreceptor cells functioning, according to a Power Point presentation by William Jones, OD, Jerome Sherman, OD, and John Potter, OD.
Micro Electric Current appears to stimulate the mitochondria to increase ATP production, according to the presentation.
In a separate presentation about age-related macular degeneration (AMD), John Potter, OD distilled some key points from the Age-Related Eye Disease Study (AREDS). “There are four things to remember from AREDS,” Dr. Potter said.
He noted the following: · AREDS Report # 8 clearly demonstrates that Category 3 AMD can be influenced by antioxidants. · One out of every five patients taking zinc and antioxidants had statistically significant improvement in distance visual acuity. · Category 3 AMD patients reduce the risk of progression by taking zinc and antioxidants. · Do not supplement patients who smoke with beta-carotene; this increases lung cancer risk.
In addition to its ocular benefits, the AMD therapy Rheopheresis may provide systemic benefits as well, including improved hearing.
According to John Potter, OD, case studies have suggested that the 2- to 4-hour continuous blood filtration procedure may result in systemic benefits.
“Rheopheresis is a novel approach to AMD,” Dr. Potter said. Occulogix Inc. is expected to seek FDA approval for the procedure in the near future.