|Articles|October 8, 2015

What you don't know about choroidal melanoma

Carol Shields, MD, and Jerry Shields, MD, of Wills Eye Hospital ocular oncology service shared their advice for what to look out for when it comes to choridal melanoma during a session at the American Academy of Optometry 2015 meeting in New Orleans.

New Orleans-Carol Shields, MD, of Wills Eye Hospital ocular oncology service, shared her advice for what to look out for when it comes to choridal melanoma during the Plenary Session at the American Academy of Optometry meeting in New Orleans.

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Choroidal nevus and melanoma

Dr.  Shields describes the relationship between choroidal nevus and melanoma as finding a rotten apple.  

“You go apple picking and among that group of fruit, there’s going to be one that goes bad. And you as eyecare specialists need to know which nevus is going to turn into melanoma,” she says. “Sometimes it’s simple; sometimes it’s very challenging.”

A recent study found that choroidal nevus occurs in approximately five percent of Caucasians and shows increasingly prevalence with age, says Dr. Shields. She estimates that most eyecare practitioners are seeing at least one patient per day with a choroidal nevus.

But that study used a database that looked only at the posterior segment of the eye-only within 45 degrees of the macula and the disc. She says that in actuality, up to 20 percent of Caucasians could have a choroidal nevus that you will have to determine whether it could be melanoma.

Dr. Shields identified a number of features that occur with choroidal nevus. These features can predict growth from nevus into melanoma:

• Nine percent have a little bit of subretinal fluid

• Six percent have overlying orange pigment

• Drusen is present in 60 percent

• Neovascularization of the choroid rarely occurs

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