title: MuSIC report III: tumour microcirculation patterns and development of metastasis in long-term follow-up of melanocytic uveal tumours.
abstract: OBJECTIVE
  To statistically determine differences in microcirculation patterns between nevi and uveal melanomas and the influence of these patterns on metastatic potential in the long-term follow-up of 112 patients with melanocytic uveal tumours. In vivo markers indicating malignancy and metastatic potential have implications for treatment decision.
  
  
  METHODS
  Primary diagnosis and work-up included clinical examination, fundus photography, standardized A and B scan echography as well as evaluation of tumour microcirculation patterns via confocal fluorescein and indocyanine green angiography (ICGA). Patient data were collected from the patient files, the tumour registry or personal contact. Statistical analysis was performed with spss 22.0 using chi-square, Fisher's exact test and Kaplan-Meier survival analysis.
  
  
  RESULTS
  Forty-three uveal melanocytic lesions remained untreated and were retrospectively classified as benign nevi, whereas 69 lesions were malignant melanomas (T1: 32, T2: 28, T3: 6 and T4: 3). 'Silent' and 'arcs without branching' were found significantly more often in nevi (p = 0.001 and p = 0.010), whereas 'parallel with cross-linking' and 'networks' were significantly more frequent in melanomas (p = 0.022 and p = 0.029). The microcirculation pattern 'parallel with cross-linking' proved significantly more frequent in patients who developed metastases (p = 0.001).
  
  
  CONCLUSIONS
  Certain microcirculation patterns may guide us in differentiating uveal nevi from malignant melanomas. A non-invasive prognostic marker can be of great value for borderline lesions in which cytology is less likely taken. 'Parallel with cross-linking' did not only indicate malignancy, but it was also associated with later tumour metastasis.
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians University, Munich, Germany.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Klingenstein
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians University, Munich, Germany.
authors.forename: Markus M
authors.initials: MM
authors.lastname: Schaumberger
authors.affiliation: Shiley Eye Center, San Diego, CA, USA.
authors.forename: William R
authors.initials: WR
authors.lastname: Freeman
authors.affiliation: Department of Biomedical Sciences, Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Folberg
authors.affiliation: Eye Clinic Augsburg, Augsburg, Germany.
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Mueller
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians University, Munich, Germany.
authors.forename: Ulrich C
authors.initials: UC
authors.lastname: Schaller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002830:Choroid Neoplasms / Q000098:blood supply* / Q000175:diagnosis / Q000628:therapy; D004396:Coloring Agents / Q000008:administration & dosage; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green / Q000008:administration & dosage; D008297:Male; D008545:Melanoma / Q000098:blood supply* / Q000175:diagnosis / Q000628:therapy; D008833:Microcirculation; D018613:Microscopy, Confocal; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis*; D009508:Nevus, Pigmented / Q000098:blood supply* / Q000175:diagnosis / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green
keywords: long-term follow-up; melanocytic uveal tumours; metastasis; microcirculation pattern; prognostic markers