This 72YO female presented with a nasal choroidal nevus seen on Optos color and Optos red channel. The lesion is flat, has overlying drusen, and measures 4.5 by 5.1 mm. Is the nevus at risk for progressing to a uveal malignant melanoma (MM)?
Learning Points:
Clinical characteristics of choroidal nevi at risk for progressing to a uveal MM were initially described by Shields et al (Ophthalmology 1995;102:1351-1361).
The most recent version of this famous acronym is To Find Small Ocular Melanoma Doing Imaging (TFSOM-DIM), which stands for To (Thickness >2mm) Find (subretinal Fluid) Small (Symptoms, vision <= 20/50) Ocular (Orange pigment) Melanoma (Melanoma hollow on ultrasonography) DIM (DIaMeter > 5mm).
Other than measuring just over 5mm in diameter, our patient has none of these other risk factors. The presence of drusen also indicates chronicity and low risk for malignant transformation.
We will follow her yearly.
