title: Iris melanocytoma: clinical features and natural course in 47 cases.
abstract: OBJECTIVE
  To describe the clinical features, natural course, management and histopathologic features of iris melanocytoma.
  
  
  METHODS
  Single-center retrospective case series.
  
  
  METHODS
  
  
  
  METHODS
  Forty-seven consecutive patients (47 eyes) with iris melanocytoma. INTERVENTION PROCEDURE: Data regarding patient and tumor features were analyzed for their impact on the main outcome measures using univariate and multivariate regression models. Kaplan-Meier estimates were used to analyze the main outcomes as a function of time.
  
  
  METHODS
  Increased intraocular pressure (IOP), tumor seeding, and tumor growth.
  
  
  RESULTS
  Associated findings at initial presentation included iris stromal seeds in 20 patients (43%), and anterior chamber angle seeds in 12 (26%). Intrinsic vascularization and sector cataract were not seen in any eyes. The management at presentation included observation in 39 patients (83%), tumor removal by sector iridectomy/iridocyclectomy in 7 (15%), and enucleation for blind painful eye with secondary increased IOP in 1 (2%). The diagnosis was confirmed by histopathologic examination in 11 patients (23%). The mean follow-up was 58 months. Using Kaplan-Meier estimates, clinical evidence of growth was observed in 23% at 5 years, 48% at 10 years, and 74% at 15 years. New tumor seeds developed in 34% at 5 years, 63% at 10 years, and 75% at 15 years. Increased IOP was observed in 11% at 5 years, 11% at 10 years, and 55% at 15 years.
  
  
  CONCLUSIONS
  Iris melanocytoma represented only 3% of all iris nevi. Related iris stromal and anterior chamber angle seeds were common, and secondary glaucoma occurred in 11% at 5 years. Growth was observed in 23% at 5 years but no malignant transformation was found.
authors.affiliation: Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
authors.forename: Hakan
authors.initials: H
authors.lastname: Demirci
authors.forename: Arman
authors.initials: A
authors.lastname: Mashayekhi
authors.forename: Carol L
authors.initials: CL
authors.lastname: Shields
authors.forename: Ralph C
authors.initials: RC
authors.lastname: Eagle
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Shields
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000869:Anterior Eye Segment / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D032801:Iridectomy; D015811:Iris Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009366:Neoplasm Seeding; D009508:Nevus, Pigmented / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies