Blue Nevi of the Ocular Surface: Clinical Characteristics, Pathologic Features, and Clinical Course

Area of Science:

• Ophthalmology
• Dermatology
• Pathology

Background:

• Blue nevus is a melanocytic tumor typically found in the skin.
• Extracutaneous blue nevi, particularly on the ocular surface, are uncommon.
• Congenital melanocytic tumors of the conjunctiva require characterization due to their rarity.

Purpose of the Study:

• To characterize the clinical features of conjunctival blue nevi.
• To describe the clinical course of these rare ocular tumors.
• To differentiate blue nevi from other conjunctival lesions like primary acquired melanosis and melanoma.

Main Methods:

• Retrospective case series of 23 surgically excised conjunctival blue nevi from 21 patients.
• Data collected from the Florida Lions Ocular Pathology Laboratory records (2000-2016).
• Pathologic diagnosis confirmed by two pathologists; specimens stained with SOX10 and CD68.

Main Results:

• The study included 23 lesions in 21 patients (mean age 55 years; 57.1% male).
• Lesions were located on the bulbar conjunctiva (13), tarsal conjunctiva (3), fornix (3), caruncle (2), episclera (1), and limbus (1).
• Pathology confirmed simple blue nevi (21 lesions) and cellular blue nevi (2 lesions); no malignant transformations were noted during a mean follow-up of 20.2 months.

Conclusions:

• Conjunctival blue nevus is a rare, deeply pigmented, congenital melanocytic lesion.
• These lesions exhibit a benign clinical course.
• Blue nevi can mimic primary acquired melanosis or conjunctival melanoma clinically.