[Risk factors of small choroidal melanocytic lesions]. / Factores de riesgo en tumores melanocíticos coroideos de pequeño tamaño.

ABSTRACT

PURPOSE: To detect the possible predictive factors of tumor spread or future growth of the small choroidal melanocytic lesions. METHODS: Retrospective review of the clinical medical histories of fourteen patients with small choroidal melanocytic lesions --< or =3mm in thickness-, which due to these features could be confused with choroidal nevus. Few clinical parameters are assessed tumor thickness, posterior tumor margin touching the optic disc, symptoms and documented tumor growth as main prognostic features. RESULTS: Tumor growth was seen in only one patient, whose tumor was treated with epiescleral iridium-192-wires, showing relapse later on. No other patient showed tumor growth, assessed by echography A-B and ocular fundus photography. One of those had symptoms with no other risk factor. Two patients had the tumor located beside the optic disc, one of which presented decreased vision and therefore we had to photocoagulate the tumor. A minimun of six months follow-up was performed in all the patients. CONCLUSIONS: With the criteria applied in our series of small choroidal melanocytic lesions, expectant observation is a valid treatment due to the small tumor growth risk. Thanks to echography and to the precise comparison between ocular fundus photographs to detect minimun growth, a simple follow-up is useful and early conservative treatment is still available.