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A Multicenter Study Validates the WHO 2022 Classification for Conjunctival Melanocytic Intraepithelial Lesions With
Hardeep Singh Mudhar1, Yamini Krishna2, Simon Cross3
1National Specialist Ophthalmic Pathology Service, Department of Histopathology, E-Floor, Royal Hallamshire Hospital, Sheffield, UK.
Summary
The WHO-EYE05 classification system for conjunctival melanocytic intraepithelial lesions (C-MIL) shows improved interobserver agreement among pathologists. This system aids in predicting clinical outcomes for noninvasive conjunctival lesions, distinguishing them from invasive melanoma.
Area of Science:
- Ophthalmology
- Pathology
- Oncology
Background:
- Existing nomenclature and grading systems for conjunctival melanocytic intraepithelial lesions (C-MIL) have varied.
- The World Health Organization (WHO) Classification of Eye Tumors has evolved, with WHO-EYE04 and WHO-EYE05 proposing different systems for C-MIL.
- WHO-EYE05 simplified high-grade C-MIL by subsuming melanoma in situ (MIS) into this category.
Conclusions:
- The WHO-EYE05 C-MIL scoring system exhibits good interobserver agreement and reproducibility, enhancing diagnostic consistency.
- This validated system aids in distinguishing noninvasive conjunctival melanocytic lesions and predicting their clinical behavior.
- The WHO-EYE05 classification provides a reliable framework for managing C-MIL and assessing the risk of progression to invasive melanoma.
