Conjunctival Nevi: Clinical Features and Therapeutic Outcomes
Received 5 March 2009; received in revised form 6 June 2009; accepted 10 June 2009. published online 05 November 2009.
Objective
To determine the epidemiology and the clinical and therapeutic outcomes of conjunctival nevi and to identify the clinical variables statistically associated with operative excision.
Design
Prospective, observational, noncomparative case series.
Participants
Two hundred fifty-five patients with the clinical diagnosis of conjunctival nevus.
Methods
Consecutive cases of conjunctival nevi managed at a single institution were studied to identify the clinical risk factors for operative excision.
Main Outcome Measures
Reasons for operative excision.
Results
Of the 255 patients who were periodically observed for a mean of 5.3 years (range, 1–11), nevi were clinically diagnosed in 140 females and 115 males and modified operative excision was performed in 75 patients (29%). The decision of operative excision was made by the surgeon in 13 cases (17%) and by the patient in 62 cases (83%). In those 13 patients, the operative decision was prompted by our concern for possible malignant transformation based on suspicious biomicroscopic features in 10 patients (13%) and photographically documented tumor growth in 3 patients (4%). For the other 62 patients who elected to undergo surgery, their reasons for excision included patient's concern for cancer in 34 cases (45%), cosmetic arguments in 9 cases (12%), and patient's request owing to lesion-induced ocular surface irritation in 19 cases (25%). Comparison between groups showed that the clinical factors at initial visit that were statistically predictive of surgical excision were the older age of the patient (P = 0.001), the largest basal tumor diameter (P<0.001), tumor location (P = 0.023), and presence of clear cysts (P = 0.013), of intrinsic vasculature (P<0.001), of prominent feeder vessels (P<0.001), and of corneal involvement (P = 0.008). None of the excised lesions showed histopathologically malignant features.
Conclusions
In our series, documented tumor growth of conjunctival nevus remained relatively a uncommon event with a incidence of 4%. Conjunctival nevi in older patients, associated with dilated feeder vessels, prominent intrinsic vasculature, and corneal involvement were more likely to be treated with operative excision.
Financial Disclosure(s)
The authors have no proprietary or commercial interest in any materials discussed in this article.
Available online: November 5, 2009.
1The Ocular Oncology Unit, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
2Center of Biostatistics and Medical Documentation, Cliniques Universitaires de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
Correspondence: Patrick De Potter, MD, PhD, Ocular Oncology Unit, Ophthalmology Department, Cliniques Universitaires UCL St-Luc, 10 Avenue Hippocrate, 1200 Brussels, Belgium
Manuscript no. 2009-321.
Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article.
ABSTRACT