Association between choroidal pigmentation and posterior uveal melanoma in a white population.
OBJECTIVE
It is well known that light skin pigmentation is a risk factor for cutaneous melanoma. The aim of this study was to investigate the analogous association between choroidal pigmentation and posterior uveal melanoma.


METHODS
Cross sectional study of 65 consecutive patients diagnosed with posterior uveal melanoma (melanoma group) and 218 consecutive patients referred for general retinal evaluation (control group). All patients were white. A clinical grading system for estimating choroidal pigmentation was developed and histologically validated in seven patients.


RESULTS
Melanoma patients with light iris colour were significantly more likely to have darker choroidal pigmentation than controls (p = 0.005). Darker choroidal pigmentation was associated histologically with increased density of choroidal melanocytes (p = 0.005).


CONCLUSIONS
Increased choroidal pigmentation, as a result of an increase in the density of pigmented choroidal melanocytes, is not protective but may actually be a risk factor for the development of posterior uveal melanoma in white patients. This finding may have implications for understanding the pathogenesis of uveal melanoma.
Harbour
J W
JW
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, Box 8069, 660 S. Euclid Avenue, St Louis, MO 63110, USA. harbour@vision.wustl.edu
Brantley
M A
MA
Hollingsworth
H
H
Gordon
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000473:pathology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005127:Eye Color; D005260:Female; D006801:Humans; D008297:Male; D008544:Melanocytes / Q000473:pathology; D008545:Melanoma / Q000473:pathology / Q000503:physiopathology*; D008875:Middle Aged; D010858:Pigmentation; D014604:Uveal Neoplasms / Q000473:pathology / Q000503:physiopathology*