Download PDF
Klin Monbl Augenheilkd 2018; 235(06): 730-739
DOI: 10.1055/s-0043-102592
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Aktuelle Diagnostik bei choroidalen Nävi

Current Diagnosis of Choroidal Nevi
J. Lüke
Klinik für Augenheilkunde, Universität zu Lübeck
,
S. Grisanti
Klinik für Augenheilkunde, Universität zu Lübeck
,
A. Tura
Klinik für Augenheilkunde, Universität zu Lübeck
› Author Affiliations
Further Information

Publication History

eingereicht 20 October 2016

akzeptiert 23 January 2017

Publication Date:
09 June 2017 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Trotz einer Vielfalt technischer Hilfsmittel zur Dokumentation und Unterstützung der Diagnosesicherung bleibt weiterhin die Abgrenzung zwischen kleinen uvealen Melanomen und großen Nävi schwierig. In vielen Fällen werden nur sorgfältige regelmäßige Kontrollen zum Ausschluss eines Wachstums bzw. zur Feststellung eines unveränderten Erscheinungsbilds empfohlen. In diesem Artikel werden unter Berücksichtigung der aktuellen Literatur die verschiedenen diagnostischen Techniken zur Dokumentation und Differenzierung von choroidalen Nävi vorgestellt.

Abstract

Despite the diversity of techniques for documentation and diagnostics of choroidal nevi, the differential diagnosis, especially regarding small uveal melanomas, remains difficult. In many cases, frequent controls to exclude growth or for the detection of an unchanged appearance are recommended. This article reviews–under consideration of the actual literature–different diagnostic techniques for documentation and differentiation of choroidal nevi.

Schlüsselwörter

Aderhautnävi - Metastasen - uveales Melanom - Autofluoreszenz - EDI-OCT

Key words

choroidal nevi - metastasis - uveal melanoma - autofluorescence - EDI-OCT
 

  • Literatur

  • 1 Zimmermann L. Melanocytes, melanocytic nevi, and melanocytomas. Invest Ophthalmol 1965; 4: 11-44
    PubMedGoogle Scholar
  • 2 Sumich O, Mitchel P, Wang J. Choroidal nevi in a white population: The Blue Mountain Eye Study. Arch Ophthalmol 1998; 116: 645-650
    CrossrefPubMedGoogle Scholar
  • 3 Naumann G, Zimmermann L, Yanoff M. Visual field defect associated with choroidal nevus. Am J Ophthalmol 1966; 62: 914-917
    CrossrefPubMedGoogle Scholar
  • 4 Gass JD. Problems in the different diagnosis of choroidal nevi and malignant melanoma. The XXXIII Edward Jackson Memorial Lecture. Am J Ophthalmol 1977; 83: 299-323
    CrossrefPubMedGoogle Scholar
  • 5 Shields CL, Furuta M, Mashayekhi A. et al. Clinical spectrum of choroidal nevi based on age at presentation in 3422 consecutive eyes. Ophthalmology 2008; 115: 546-552
    CrossrefPubMedGoogle Scholar
  • 6 Nauman G, Yanoff M, Zimmermann L. Histogenesis of malignant melanomas of the uvea. I. Histopathologic characteristics of nevi of the choroids and ciliary body. Arch Ophthalmol 1966; 6: 784-796
    PubMedGoogle Scholar
  • 7 Rohrbach JM, Sobottka B. Tumoren der Choroidea, Nävus. In: Rohrbach JM, Lieb WE. Hrsg. Tumoren des Auges und seiner Adnexe, Textbuch und Atlas unter besonderer Berücksichtigung des klinischen und morphologischen Bildes. 1st ed.. Stuttgart: 1998: 119-121
    Google Scholar
  • 8 Brown G, Shields J, Augsburger J. Amelanotic choroidal nevi. Ophthalmology 1981; 88: 1116-1121
    CrossrefPubMedGoogle Scholar
  • 9 Shields CL, Maktabi AM, Jahnle E. et al. Halo nevus of the choroid in 150 patients. Arch Ophthalmol 2010; 7: 859-864
    PubMedGoogle Scholar
  • 10 Fournier G, Albert D, Wagoner M. Choroidal halo nevus occuring in a patient with vitiligo. Surv Ophthalmol 1984; 28: 671-672
    CrossrefPubMedGoogle Scholar
  • 11 Li HK, Shields CL, Mashayekhi A. et al. Giant choroidal nevi: clinical features and natural course in 322 cases. Ophthalmology 2010; 117: 324-333
    CrossrefPubMedGoogle Scholar
  • 12 Gass J. Stereoscopic Atlas of macular Disease. 3rd ed.. St Louis: Mosby; 1997
    Google Scholar
  • 13 Lewis DA, Albert DM. Choroidal Nevi. III. Retina. 5th ed. Philadelphia: Elsevier Saunders; 2013
    Google Scholar
  • 14 Mashaysekhi A, Siu S, Shields CL. et al. Slow enlargement of choroidal nevi: a long-term follow-up study. Ophthalmology 2011; 118: 382-388
    CrossrefPubMedGoogle Scholar
  • 15 Singh AD, Mokashi AA, Bena JF. et al. Small choroidal melanocytic lesions: features predictive of growth. Ophthalmology 2006; 113: 1032-1039
    CrossrefPubMedGoogle Scholar
  • 16 Font R, Zimmermann L, Armaly M. The nature of the orange pigment over a choroidal melanoma: histochemical and electron microscopical observations. Arch Ophthalmol 1974; 91: 359-362
    CrossrefPubMedGoogle Scholar
  • 17 Smith LT, Irvine AR. Diagnostic significance of orange pigment accumulation over choroidal tumors. Mod Probl Ophthalmol 1974; 12: 536-543
    PubMedGoogle Scholar
  • 18 Pro M, Shields J, Timer T. Serous detachment of macula associated with presumed choroidal nevi. Arch Ophthalmol 1978; 85: 704-710
    PubMedGoogle Scholar
  • 19 Folk JC, Weingeist TA, Coonan P. et al. The treatment of serous macular detachment secondary to choroidal melanoma and nevi. Ophthalmology 1989; 96: 547-551
    CrossrefPubMedGoogle Scholar
  • 20 Shields CL, Furuta M, Mashayekhi A. et al. Visual acuity in 3422 consecutive eyes with choroidal nevus. Arch Ophthalmol 2007; 11: 1501-1507
    PubMedGoogle Scholar
  • 21 Flindall R, Drance S. Visual field studies of benign choroidal melanoma. Arch Ophthalmol 1969; 81: 41-44
    CrossrefPubMedGoogle Scholar
  • 22 Gonder J, Ezell P, Shields J. et al. Ocular melanocytosis: a study to determine the prevalence rate of ocular melanocytosis. Ophthalmology 1982; 89: 950-952
    CrossrefPubMedGoogle Scholar
  • 23 Mishima Y, Mevorah B. Nevus of Ota and nevus of Ito in American Negroes. J Invest Dermatol 1961; 36: 133-154
    CrossrefPubMedGoogle Scholar
  • 24 Croxatto J, Charles D, Malbran E. Neurofibromatosis associated with nevus of Ota and choroidal melanoma. Am J Ophthalmol 1981; 92: 578-589
    CrossrefPubMedGoogle Scholar
  • 25 Dutton J, Anderson R, Schleper R. et al. Orbital malignant melanoma and oculodermal melanocytosis: report of two cases and review of the literature. Ophthalmology 1984; 90: 497-507
    PubMedGoogle Scholar
  • 26 Yanoff M, Zimmermann L. Histogenesis of malignant melanomas of the uvea III. Relationship of congenital ocular melanocytosis and neurofibromatosis to uveal melanomas. Arch Ophthalmol 1967; 77: 331-336
    CrossrefPubMedGoogle Scholar
  • 27 Caporaso N, Greene MH, Tsai S. et al. Cytogenetics in hereditary malignant melanoma and dysplastic nevus syndrome: is dysplastic nevus syndrome a chromosome instability disorder?. Cancer Genet Cytogenet 1987; 24: 299-314
    CrossrefPubMedGoogle Scholar
  • 28 Albert D, Chang M, Lamping K. et al. The dysplastic nevus syndrome: a pedigree with primary malignant melanoma of the choroid and skin. Ophthalmology 1985; 92: 1728-1734
    CrossrefPubMedGoogle Scholar
  • 29 Albert D, Searl S, Forget B. et al. Uveal findings in patients with cutaneous melanoma. Am J Ophthalmol 1983; 95: 474-479
    CrossrefPubMedGoogle Scholar
  • 30 Rodriguez-Sains R. Ocular findings in patients with dysplastic nevus syndrome. Ophthalmology 1986; 93: 661-665
    CrossrefPubMedGoogle Scholar
  • 31 Gass JD, Gieser RG, Wilkinson CP. et al. Bilateral diffuse uveal melanocytic proliferation in patients with occult carcinoma. Arch Ophthalmol 1990; 108: 527-533
    CrossrefPubMedGoogle Scholar
  • 32 Margo C, Pavan P, Gendelman D. et al. Bilateral melanocytic uveal tumors associated with systemic nodular malignancy: malignant melanomas or benign paraneoplastic syndrome. Retina 1987; 7: 137-141
    CrossrefPubMedGoogle Scholar
  • 33 McLean IW, Zimmermann LE, Evans RM. Reappraisal of Callenderʼs spindle a type of malignant melanoma of choroid and ciliary body. Am J Ophthalmol 1978; 86: 557-564
    CrossrefPubMedGoogle Scholar
  • 34 Gass J. Observations of suspect choroidal and ciliary body melanomas for evidence of growth prior to enucleation. Ophthalmology 1980; 87: 523-528
    CrossrefPubMedGoogle Scholar
  • 35 Rohrbach JM, Sobottka B. Tumoren der Choroidea. Bilaterale uveale Hyperplasie. In: Rohrbach JM, Lieb WE. Hrsg. Tumoren des Auges und seiner Adnexe, Textbuch und Atlas unter besonderer Berücksichtigung des klinischen und morphologischen Bildes. 1st ed.. Stuttgart: 1998: 136-138
    Google Scholar
  • 36 Shields CL, Mashayekhi A, Ho T. et al. Solitary congenital hypertrophy of the retinal pigment epithelium: clinical features and frequency of enlargement in 330 patients. Ophthalmology 2003; 110: 1968-1976
    CrossrefPubMedGoogle Scholar
  • 37 Mashayekhi A, Siu S, Shields CL. et al. Slow enlargement of choroidal nevi: a long-term follow-up study. Ophthalmology 2011; 118: 382-388
    CrossrefPubMedGoogle Scholar
  • 38 Tamler E. A clinical study of choroidal nevi. A follow-up report. Arch Ophthalmol 1970; 84: 29-32
    CrossrefPubMedGoogle Scholar
  • 39 Tamler E, Maumenee A. A clinical study of choroidal nevi. AMA Arch Ophthalmol 1959; 62: 196-202
    CrossrefPubMedGoogle Scholar
  • 40 Mims J, Shields J. Follow-up studies of suspicious choroidal nevi. Ophthalmology 1978; 85: 929-943
    CrossrefPubMedGoogle Scholar
  • 41 Shields JA, Augsburger JJ, Brown GC. et al. The differential diagnosis of posterior uveal melanoma. Ophthalmology 1980; 87: 518-522
    CrossrefPubMedGoogle Scholar
  • 42 Shields CL, Furuta M, Berman EL. et al. Choroidal nevus transformation into melanoma: analysis of 2514 consecutive cases. Arch Ophthalmol 2009; 127: 981-987
    CrossrefPubMedGoogle Scholar
  • 43 Shields CL, Shields JA, Kiratli H. et al. Risk factors for growth and metastasis of small choroidal melanocytic tumors. Ophthalmology 1995; 102: 1351-1361
    CrossrefPubMedGoogle Scholar
  • 44 Chien JL, Sioufi K, Surakiatchanukul T. et al. Choroidal nevus: a review of prevalence, features, genetics, risks, and outcomes. Curr Opin Ophthalmol 2017; 28: 228-237
    CrossrefPubMedGoogle Scholar
  • 45 Callanan DG, Lewis ML, Byrne SF. et al. Choroidal neovascularization associated with choroidal nevi. Arch Ophthalmol 1993; 11: 789-794
    PubMedGoogle Scholar
  • 46 Shields CL, Mashayekhi A, Materin MA. et al. Optical coherence tomography of choroidal nevus in 120 patients. Retina 2005; 25: 243-252
    CrossrefPubMedGoogle Scholar
  • 47 Espinoza G, Rosenblatt B, Harbour JW. Optical coherence tomography in the evaluation of retinal changes associated with suspicious choroidal melanocytic tumors. Am J Ophthalmol 2004; 137: 90-95
    CrossrefPubMedGoogle Scholar
  • 48 Yoshida K. Nevus fuscocaerulus ophthalmomaxillaris Ota. Tohoku J Exp Med 1952; 55: 34-43
    CrossrefPubMedGoogle Scholar
  • 49 Shields CL, Kaliki S, Rojanaporn D. et al. Enhanced depth imaging optical coherence tomography of small choroidal melanoma: comparison with choroidal nevus. Arch Ophthalmol 2012; 130: 850-856
    CrossrefPubMedGoogle Scholar
  • 50 Almeida A, Kaliki S, Shields CL. Autofluorescence of intraocular tumours. Curr Opin Ophthalmol 2013; 24: 222-232
    CrossrefPubMedGoogle Scholar
  • 51 Torres VL, Brugnoni N, Kaiser PK. et al. Optical coherence tomography enhanced depth imaging of choroidal tumors. Am J Ophthalmol 2011; 151: 586-593
    CrossrefPubMedGoogle Scholar
  • 52 Maloca P, Gyger C, Hasler PW. A pilot study to compartmentalize small melanocytic choroidal tumors and choroidal vessels with speckle-noise free 1050 nm swept source optical coherence tomography (OCT choroidal “tumoropsy”). Graefes Arch Clin Exp Ophthalmol 2016; 254: 1211-1219
    CrossrefPubMedGoogle Scholar
  • 53 Maloca P, Gyger C, Hasler PW. A pilot study to image the vascular network of small melanocytic choroidal tumors with speckle noise-free 1050-nm swept source optical coherence tomography (OCT choroidal angiography). Graefes Arch Clin Exp Ophthalmol 2016; 254: 1201-1210
    CrossrefPubMedGoogle Scholar
  • 54 Yannuzzi LA, Ober MD, Slakter JS. et al. Ophthalmic fundus imaging: today and beyond. Am J Ophthalmol 2004; 137: 511-524
    CrossrefPubMedGoogle Scholar
  • 55 Lavinsky D, Belfort RN, Navajas E. et al. Fundus autofluorescence of choroidal nevus and melanoma. Br J Ophthalmol 2007; 91: 1299-1302
    CrossrefPubMedGoogle Scholar
  • 56 Materin MA, Raducu R, Bianciotto C. et al. Fundus autofluorescence and optical coherence tomography findings in choroidal melanocytic lesions. Middle East Afr J Ophthalmol 2010; 17: 201-206
    CrossrefPubMedGoogle Scholar
  • 57 Albertus DL, Schachar IH, Zahid S. et al. Autofluorescence quantification of benign and malignant choroidal nevomelanocytic tumors. JAMA Ophthalmol 2013; 131: 1004-1008
    CrossrefPubMedGoogle Scholar
  • 58 Reznicek L, Stumpf C, Seidensticker F. et al. Role of wide-field autofluorescence imaging and scanning laser ophthalmoscopy in differentiation of choroidal pigmented lesions. Int J Ophthalmol 2014; 7: 697-703
    PubMedGoogle Scholar
  • 59 Shields CL, Pirondini C, Bianciotto C. et al. Autofluorescence of choroidal nevus in 64 cases. Retina 2008; 28: 1035-1043
    CrossrefPubMedGoogle Scholar
  • 60 Wollf-Korman P, Korman B, Hazeneratz G. Duplex and color Doppler ultrasound in differential diagnosis of choroidal tumors. Acta Ophthalmol 1992; 204: 66-70
    PubMedGoogle Scholar
  • 61 Singh AD, Medina CA, Singh N. et al. Fine-needle aspiration biopsy of uveal melanoma: outcomes and complications. Br J Ophthalmol 2016; 100: 456-462
    CrossrefPubMedGoogle Scholar
  • 62 Aaberg jr. TM, Cook RW, Oelschlager K. et al. Current clinical practice: differential management of uveal melanoma in the era of molecular tumor analyses. Clin Ophthalmol 2014; 8: 2449-2460
    PubMedGoogle Scholar
  • 63 Maat W, Jordanova ES, van Zelderen-Bhola SL. et al. The heterogeneous distribution of monosomy 3 in uveal melanomas: implications for prognostication based on fine-needle aspiration biopsies. Arch Pathol Lab Med 2007; 131: 91-96
    PubMedGoogle Scholar
  • 64 Schoenfield L, Pettay J, Tubbs RR. et al. Variation of monosomy 3 status within uveal melanoma. Arch Pathol Lab Med 2009; 133: 1219-1222
    PubMedGoogle Scholar
  • 65 Mensink HW, Vaarwater J, Kilic E. et al. Chromosome 3 intratumor heterogeneity in uveal melanoma. Invest Ophthalmol Vis Sci 2009; 50: 500-504
    CrossrefPubMedGoogle Scholar
  • 66 Midena E, Bonaldi L, Parrozzani R. et al. In vivo detection of monosomy 3 in eyes with medium-sized uveal melanoma using transscleral fine needle aspiration biopsy. Eur J Ophthalmol 2006; 16: 422-425
    CrossrefPubMedGoogle Scholar
  • 67 Young TA, Rao NP, Glasgow BJ. et al. Fluorescent in situ hybridization for monosomy 3 via 30-gauge fine-needle aspiration biopsy of choroidal melanoma in vivo. Ophthalmology 2007; 114: 142-146
    CrossrefPubMedGoogle Scholar
  • 68 Singh AD, Medina CA, Singh N. et al. Fine-needle aspiration biopsy of uveal melanoma: outcomes and complications. Br J Ophthalmol 2016; 100: 456-462
    CrossrefPubMedGoogle Scholar
  • 69 Onken MD, Worley LA, Harbour JW. Association between gene expression profile, proliferation and metastasis in uveal melanoma. Curr Eye Res 2010; 35: 857-863
    CrossrefPubMedGoogle Scholar
  • 70 Harbour JW. A prognostic test to predict the risk of metastasis in uveal melanoma based on a 15-gene expression profile. Methods Mol Biol 2014; 1102: 427-440
    PubMedGoogle Scholar
  • 71 Harbour JW, Chen R. The DecisionDx-UM gene expression profile test provides risk stratification and individualized patient care in uveal melanoma. PLoS Curr 2013; DOI: 10.1371/currents.eogt.af8ba80fc776c8f1ce8f5dc485d4a618.
    PubMedGoogle Scholar
  • 72 Pereira PR, Odashiro AN, Lim LA. et al. Current and emerging treatment options for uveal melanoma. Clin Ophthalmol 2013; 7: 1669-1682
    PubMedGoogle Scholar
  • 73 Onken MD, Worley LA, Char DH. et al. Collaborative Ocular Oncology Group report number 1: prospective validation of a multi-gene prognostic assay in uveal melanoma. Ophthalmology 2012; 119: 1596-1603
    CrossrefPubMedGoogle Scholar
  • 74 Augsburger JJ, Corrêa ZM, Augsburger BD. Frequency and implications of discordant gene expression profile class in posterior uveal melanomas sampled by fine needle aspiration biopsy. Am J Ophthalmol 2015; 159: 248-256
    CrossrefPubMedGoogle Scholar
  • 75 Harbour JW, Onken MD, Roberson ED. et al. Frequent mutation of BAP1 in metastasizing uveal melanomas. Science 2010; 330: 1410-1413
    CrossrefPubMedGoogle Scholar
  • 76 Harbour JW, Roberson ED, Anbunathan H. et al. Recurrent mutations at codon 625 of the splicing factor SF3B1 in uveal melanoma. Nat Genet 2013; 45: 133-135
    CrossrefPubMedGoogle Scholar
  • 77 Onken MD, Worley LA, Long MD. et al. Oncogenic mutations in GNAQ occur early in uveal melanoma. Invest Ophthalmol Vis Sci 2008; 49: 5230-5234
    CrossrefPubMedGoogle Scholar
  • 78 Van Raamsdonk CD, Bezrookove V, Green G. et al. Frequent somatic mutations of GNAQ in uveal melanoma and blue naevi. Nature 2009; 457: 599-602
    CrossrefPubMedGoogle Scholar
  • 79 Van Raamsdonk CD, Griewank KG, Crosby MB. et al. Mutations in GNA11 in uveal melanoma. N Engl J Med 2010; 363: 2191-2199
    CrossrefPubMedGoogle Scholar
  • 80 Decatur CL, Ong E, Garg N. et al. Driver mutations in uveal melanoma: associations with gene expression profile and patient outcomes. JAMA Ophthalmol 2016; 134: 728-733
    CrossrefPubMedGoogle Scholar
  • 81 Albert D, Robinson N, Fulton A. et al. Epidemiologic investigation of increased incidence of choroidal melanoma in a single population of chemical workers. Int Ophthalmol Clin 1980; 20: 71-92
    PubMedGoogle Scholar
  • 82 Ganley J, Comstock G. Benign nevi and malignant melanomas of the choroid. Am J Ophthalmol 1973; 76: 19-25
    CrossrefPubMedGoogle Scholar
  • 83 Singh AD, Kalyaniu P, Topham A. Estimating the risk of malignant transformation of a choroidal nevus. Ophthalmology 2005; 112: 1784-1789
    CrossrefPubMedGoogle Scholar
  • 84 Blum ES, Yang J, Komatsubara KM. et al. Clinical management of uveal and conjunctival melanoma. Oncology (Williston Park) 2016; 30: 29-32 34–43, 48
    PubMedGoogle Scholar
  • 85 Midena E, Parrozzani R. Biopsies in uveal melanoma. Dev Ophthalmol 2012; 49: 81-95
    PubMedGoogle Scholar
  • 86 Eide N, Walaas L. Fine-needle aspiration biopsy and other biopsies in suspected intraocular malignant disease: a review. Acta Ophthalmol 2009; 87: 588-601
    CrossrefPubMedGoogle Scholar
  • 87 Grixti A, Angi M, Damato BE. et al. Vitreoretinal surgery for complications of choroidal tumor biopsy. Ophthalmology 2014; 121: 2482-2488
    CrossrefPubMedGoogle Scholar