title: Combination of clinical factors predictive of growth of small choroidal melanocytic tumors.
abstract: OBJECTIVE
  To better define the effect of individual risk factors and combinations thereof on the growth of small choroidal melanocytic tumors.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Clinical practice of ocular oncology.
  
  
  METHODS
  The study included 1287 patients with small suspicious choroidal melanocytic tumors, measuring 3 mm or less in thickness, managed with observation.
  
  
  RESULTS
  On multivariate analysis, the clinical risk factors predictive of growth of small choroidal melanocytic tumors include tumor thickness greater than 2.0 mm, posterior tumor margin touching the disc, visual symptoms, orange pigment, and subretinal fluid. Tumor growth was detected in 4% of those patients with no risk factors. Growth was detected in approximately 36% of patients with 1 risk factor, 45% of patients with 2 risk factors, 50% of patients with 3 risk factors, 51% of patients with 4 risk factors, and 56% of patients with all 5 risk factors. The combination of risk factors offering the greatest risk for growth was tumor thickness greater than 2.0 mm, tumor margin touching disc, and subretinal fluid that was associated with tumor growth in 63% of the affected patients. The relative risk for growth was 1.9 for 1 factor, 3.8 for 2 factors, 7.4 for 3 factors, 14.1 for 4 factors, and 27.1 for all 5 risk factors combined.
  
  
  CONCLUSIONS
  Five risk factors for growth of small choroidal melanocytic tumors have been identified. The combinations of various factors increase the risk for tumor growth from 4% if no factors are present to more than 50% if 3 or more risk factors are present. These factors may be important when counseling patients with small suspicious choroidal melanocytic tumors.
authors.affiliation: Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Shields
authors.forename: J
authors.initials: J
authors.lastname: Cater
authors.forename: J A
authors.initials: JA
authors.lastname: Shields
authors.forename: A D
authors.initials: AD
authors.lastname: Singh
authors.forename: M C
authors.initials: MC
authors.lastname: Santos
authors.forename: C
authors.initials: C
authors.lastname: Carvalho
mesh_terms: D002830:Choroid Neoplasms / Q000473:pathology*; D005654:Fundus Oculi; D006801:Humans; D008544:Melanocytes / Q000473:pathology*; D008545:Melanoma / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors