Weekend Bytes - Differentiating Choroidal melanoma from Choroidal Nevus

How do we distinguish a choroidal melanoma from a choroidal nevus?

Remember the menominc TFSOM-UHHD - 'To Find Small Ocular Melanomas Using Helpful Hints Daily'

SWIPE TO SEE!

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Conjunctival Nevus

- Nevi are congenital benign melanocytic tumors.

- Classified into junctional, subepithelial, compound, and blue nevus.

- Most common melanocytic conjunctival tumors.

- They are more common in Caucasians and appear within the first two decades of life.

CLINICAL FEATURES:

- Presents from childhood

- Most common site: Interpalpebral conjunctiva near the limbus (no corneal invasion)

- Mostly unilateral

- Usualy stationary - but can exhibit growth due to hormonal changes or local inflammation.

- Light-brown, slightly raised lesion.

- Presence of microcysts

- Well-defined margins

- Can change pigmentation with puberty and pregnancy

- No episcleral fixation/ intrinsic vascularity

- Chance of malignancy is very rare - 1%

INVESTIGATIONS

- AS-OCT - Appearance of cystic spaces

- Histopathology - nests of nevus cells that are present in the junctional and subepithelial area of the conjunctiva.

MANAGEMENT

- Observe

- Very rarely - Excision when growth or change in color is noted

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Weekend Bytes - Why do HST's occur?

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