Abstract
Background Melanocytic proliferations in the conjunctiva, i.e. nevus, primary acquired melanosis (PAM) and malignant melanoma, account for up to 53% of all conjunctival neoplasms. A biopsy is often necessary to correctly diagnose a pigmented lesion. It is a challenge for clinicians and pathologists how to best manage these lesions, especially the premalignant types. Purpose To compare international guidelines and recommended practice for management of pigmented conjunctival lesions with the management and treatment used at The department of ophthalmology at Oslo University Hospital (OUS), Ullevål. Method We searched for review articles published during the last 10 years for international guidelines and recommended practice, ophthalmological textbooks and Internet sites. To obtain information about current clinical practice at the Department of Ophthalmology at OUS; we conducted an interview with surgeons. The data we obtained from this interview was compared with international guidelines. Results Biopsy with removal of the lesion is recommended if there is any suspicion of atypia or malignancy or if there is uncertainty of the exact nature of the lesion. If there is suspicion of malignancy, additional cryotherapy is performed at the time of biopsy. A nevus and a PAM without atypia when removed doesn´t need follow up. If PAM with atypia or malignant melanoma is found, follow up is necessary and additional treatment with mitomycin is recommended. Conclusion Pigmented lesions of the conjunctiva carry a risk of malignancy with a potentially fatal outcome for the patients. We found that The department of ophthalmology use up-to-date treatment along with international guidelines.
Background Melanocytic proliferations in the conjunctiva, i.e. nevus, primary acquired melanosis (PAM) and malignant melanoma, account for up to 53% of all conjunctival neoplasms. A biopsy is often necessary to correctly diagnose a pigmented lesion. It is a challenge for clinicians and pathologists how to best manage these lesions, especially the premalignant types. Purpose To compare international guidelines and recommended practice for management of pigmented conjunctival lesions with the management and treatment used at The department of ophthalmology at Oslo University Hospital (OUS), Ullevål. Method We searched for review articles published during the last 10 years for international guidelines and recommended practice, ophthalmological textbooks and Internet sites. To obtain information about current clinical practice at the Department of Ophthalmology at OUS; we conducted an interview with surgeons. The data we obtained from this interview was compared with international guidelines. Results Biopsy with removal of the lesion is recommended if there is any suspicion of atypia or malignancy or if there is uncertainty of the exact nature of the lesion. If there is suspicion of malignancy, additional cryotherapy is performed at the time of biopsy. A nevus and a PAM without atypia when removed doesn´t need follow up. If PAM with atypia or malignant melanoma is found, follow up is necessary and additional treatment with mitomycin is recommended. Conclusion Pigmented lesions of the conjunctiva carry a risk of malignancy with a potentially fatal outcome for the patients. We found that The department of ophthalmology use up-to-date treatment along with international guidelines.