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Comment published on 15 March 2021, see Cancers 2021, 13(6), 1306.
Article

Detecting Progression of Melanocytic Choroidal Tumors by Sequential Imaging: Is Ultrasonography Necessary?

1
Ocular Oncology Service, Moorfields Eye Hospital, London EC1V 2PD, UK
2
Department of Ophthalmology, Ocular Oncology Clinic, Royal Victorian Eye and Ear Hospital, Melbourne 3002, Australia
3
NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and University College London Institute of Ophthalmology, London EC1V 9EL, UK
4
Nuffield Laboratory of Ophthalmology, University of Oxford, London OX3 9DU, UK
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(7), 1856; https://doi.org/10.3390/cancers12071856
Received: 5 June 2020 / Revised: 20 June 2020 / Accepted: 7 July 2020 / Published: 10 July 2020
Purpose: To determine if ultrasonography is necessary to detect progression of choroidal melanocytic tumors undergoing sequential multi-modal imaging with color photography, autofluorescence (AF) and optical coherence tomography (OCT). Methods: All patients with choroidal melanoma undergoing treatment at Moorfields Eye Hospital between January 2016 and March 2020 were reviewed to identify those with treatment deferred by ≥2 months. Tumors that showed progression prior to treatment, defined as an increase in (a) basal dimensions (b) thickness (c) orange pigment and/or (d) sub-retinal fluid, were included. Mushroom shape, Orange pigment, Large size, Enlargement and Sub-retinal fluid (MOLES) scores were assigned to all tumors at earliest date and date of treatment. Results: A total of 99 patients with a mean age of 66 years (range: 26–90) were included. The initial MOLES score was 1 in 2 cases, 2 in 23 cases, and ≥3 in 74 cases. Progression was detected with sequential color photography alone in 100% of MOLES 1/2 and 97% of lesions with a MOLES score of ≥3. When findings on AF and OCT were included, sensitivity for detecting subtle change without ultrasonography improved to 100% for MOLES 3 and 97% for MOLES 4/5. Only one patient included in this study had an isolated increase in thickness that may have been missed had sequential ultrasonography not been performed. Overall, the sensitivity for detecting progression with color photographs alone was 97% (95% CI 93–100%) and increased to 99% (95% CI 97–100%) by including autofluorescence and OCT. Conclusions: Monitoring of choroidal nevi, particularly those classified as MOLES 1 or 2 (i.e., low-risk or high-risk naevi), can be accomplished safely without the need for ultrasonography. The findings of this study may remove barriers to the implementation of tele-oncology clinics for the monitoring of choroidal melanocytic tumors. View Full-Text
Keywords: choroidal nevus; choroidal melanoma; ultrasound; optical coherence tomography; autofluorescence; tele-ophthalmology choroidal nevus; choroidal melanoma; ultrasound; optical coherence tomography; autofluorescence; tele-ophthalmology
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MDPI and ACS Style

Roelofs, K.A.; O’Day, R.; Al Harby, L.; Hay, G.; Arora, A.K.; Cohen, V.M.L.; Sagoo, M.S.; Damato, B.E. Detecting Progression of Melanocytic Choroidal Tumors by Sequential Imaging: Is Ultrasonography Necessary? Cancers 2020, 12, 1856. https://doi.org/10.3390/cancers12071856

AMA Style

Roelofs KA, O’Day R, Al Harby L, Hay G, Arora AK, Cohen VML, Sagoo MS, Damato BE. Detecting Progression of Melanocytic Choroidal Tumors by Sequential Imaging: Is Ultrasonography Necessary? Cancers. 2020; 12(7):1856. https://doi.org/10.3390/cancers12071856

Chicago/Turabian Style

Roelofs, Kelsey A., Roderick O’Day, Lamis Al Harby, Gordon Hay, Amit K. Arora, Victoria M.L. Cohen, Mandeep S. Sagoo, and Bertil E. Damato 2020. "Detecting Progression of Melanocytic Choroidal Tumors by Sequential Imaging: Is Ultrasonography Necessary?" Cancers 12, no. 7: 1856. https://doi.org/10.3390/cancers12071856

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