Choroidal Nevus Features Associated with Subspecialty Referral.

Area of Science:

• Ophthalmology
• Oncology
• Medical Imaging

Background:

• Choroidal nevi are common melanocytic tumors of the eye.
• Referral patterns for choroidal nevi to subspecialists are not well-defined.
• Identifying features prompting subspecialty referral is crucial for timely management.

Purpose of the Study:

• To determine specific features of choroidal nevi that are associated with referral to retina or ocular oncology subspecialists.
• To analyze demographic and tumor characteristics influencing subspecialty care decisions.

Main Methods:

• Retrospective population-based cohort study.
• Analysis of 826 incident choroidal nevus diagnoses from Olmsted County, Minnesota (2006-2015).
• Statistical assessment of tumor features and demographics linked to subspecialty referral.

Main Results:

• 11% of choroidal nevi (88/826) were referred, primarily to ocular oncology (67%).
• Referral was associated with larger basal diameter (mean 4.6 mm vs 2.4 mm) and thickness (0.7 mm vs 0.1 mm).
• Halo around nevus and drusen on OCT were also linked to referral, while orange pigment and subretinal fluid were not significant predictors.

Conclusions:

• Increased basal diameter and thickness are key indicators for referring choroidal nevi.
• Certain high-risk features for melanoma transformation are under-recognized in referral decisions.
• Enhanced provider education on high-risk features and imaging guidelines is recommended to improve early detection and management.