Melanocytic lesions of the iris--a clinocopathological study of 100 cases

Between 1958 and 1985 (28 years), 100 melanocytic lesions of the iris were submitted to the Pathology Department of the Royal Victorian Eye and Ear Hospital (RVEEH). A clinicopathological correlation of these cases was performed. The mean age at presentation was 42.6 years (range 12 to 79 years). The average duration of a visible lesion prior to surgery was 5.7 years (range two weeks to 47 years). Most patients presented with an iris tumour with or without a recent increase in size. Less frequent presentations were: pupil abnormalities, visual disturbances, raised intraocular pressure, iridocylitis, 'cyst' formation and hyphaema. Angle involvement was noted in 36 patients, either clinically or pathologically. The cases were morphologically classified as melanocytic naevi (9%), low-grade malignant melanoma (79%), and high-grade malignant melanoma (12%). Detailed follow-up was obtained for 51 patients. Follow-up ranged from one to 27 years and was greater than five years in 35 patients. There were six recurrences (11.8%) and two patients developed metastases (3.9%). Five of the recurrences were classified as low-grade malignant melanoma. The two metastases and the other recurrences were from the high-grade malignant melanoma category.