title: Conjunctival nevi clinical features and therapeutic outcomes.
abstract: OBJECTIVE
  To determine the epidemiology and the clinical and therapeutic outcomes of conjunctival nevi and to identify the clinical variables statistically associated with operative excision.
  
  
  METHODS
  Prospective, observational, noncomparative case series.
  
  
  METHODS
  Two hundred fifty-five patients with the clinical diagnosis of conjunctival nevus.
  
  
  METHODS
  Consecutive cases of conjunctival nevi managed at a single institution were studied to identify the clinical risk factors for operative excision.
  
  
  METHODS
  Reasons for operative excision.
  
  
  RESULTS
  Of the 255 patients who were periodically observed for a mean of 5.3 years (range, 1-11), nevi were clinically diagnosed in 140 females and 115 males and modified operative excision was performed in 75 patients (29%). The decision of operative excision was made by the surgeon in 13 cases (17%) and by the patient in 62 cases (83%). In those 13 patients, the operative decision was prompted by our concern for possible malignant transformation based on suspicious biomicroscopic features in 10 patients (13%) and photographically documented tumor growth in 3 patients (4%). For the other 62 patients who elected to undergo surgery, their reasons for excision included patient's concern for cancer in 34 cases (45%), cosmetic arguments in 9 cases (12%), and patient's request owing to lesion-induced ocular surface irritation in 19 cases (25%). Comparison between groups showed that the clinical factors at initial visit that were statistically predictive of surgical excision were the older age of the patient (P = 0.001), the largest basal tumor diameter (P<0.001), tumor location (P = 0.023), and presence of clear cysts (P = 0.013), of intrinsic vasculature (P<0.001), of prominent feeder vessels (P<0.001), and of corneal involvement (P = 0.008). None of the excised lesions showed histopathologically malignant features.
  
  
  CONCLUSIONS
  In our series, documented tumor growth of conjunctival nevus remained relatively a uncommon event with a incidence of 4%. Conjunctival nevi in older patients, associated with dilated feeder vessels, prominent intrinsic vasculature, and corneal involvement were more likely to be treated with operative excision.
  
  
  BACKGROUND
  The authors have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: The Ocular Oncology Unit, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Laurent
authors.initials: L
authors.lastname: Levecq
authors.forename: Patrick
authors.initials: P
authors.lastname: De Potter
authors.forename: Jacques
authors.initials: J
authors.lastname: Jamart
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003230:Conjunctival Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome