From the Department of Ophthalmic Oncology (Y.S.Y., Z.O., J.W., A.D.S.), Cole Eye Institute, Cleveland, Ohio, USA.
Wilmer Eye Institute (N.S.), Johns Hopkins University, Baltimore, Maryland, USA.
Am J Ophthalmol. 2024 Oct;266:102-109. doi: 10.1016/j.ajo.2024.05.021. Epub 2024 May 17.
To explore size, growth, and topographic distribution of choroidal nevi in children to gain insights into choroidal nevogenesis.
Retrospective consecutive case series using pediatric clinic - and population-study data, comparing to adult data.
Clinical data from Cole Eye Institute (CEI) database (December 2005-January 2023) was derived from a retrospective consecutive case series of 20 children (< 20 years) with choroidal nevi. For population data, 48 children from previously reported pooled data of the participants of the Sydney Pediatric Eye Disease Study, Sydney Myopia Study, Sydney Childhood Eye Study, and Sydney Adolescent Vascular and Eye Disease Study were included. Fundus photographs were reviewed and the locations of 18 choroidal nevi seen at CEI with widefield imaging were mapped on a radial scatter plot. For comparison, 100 consecutive adults with choroidal nevi were identified from CEI database. Main outcomes were size, growth, and topographic distribution of choroidal nevi.
The median largest basal diameter was 1.6 mm (range 0.4-4.2) in children. Most choroidal nevi (75%) remained stable, and 16% demonstrated growth at follow-up. The mean growth rate was calculated as 0.12 mm/year (range 0.10-0.15). Malignant transformation was not noted during childhood. All secondary changes (drusen, orange pigment, and subretinal fluid) associated with choroidal nevi in children were less common than those in adults (p < .05). Choroidal nevi in children were located significantly more posterior than in adults. The median distance to fovea was 2.1 mm (range 0.5-8.5) in children and 5.1 mm (range 0.4-16) in adults (p < .0001).
The onset and growth of choroidal nevi in children suggest active choroidal nevogenesis in childhood. A posterior topographic distribution may support the developmental framework for migration and maturation of choroidal melanoblasts.
探讨儿童脉络膜痣的大小、生长和分布情况，以深入了解脉络膜痣的发生机制。
利用小儿眼科诊所和人群研究数据进行回顾性连续病例系列研究，并与成人数据进行比较。
从 Cole Eye Institute（CEI）数据库（2005 年 12 月至 2023 年 1 月）中获取 20 名（<20 岁）脉络膜痣患儿的临床数据，这些患儿均来自回顾性连续病例系列研究。为了获取人群数据，纳入了先前报道的来自悉尼小儿眼病研究、悉尼近视研究、悉尼儿童眼研究和悉尼青少年血管和眼病研究参与者的 48 名儿童的数据。对眼底照片进行了回顾，并将在 CEI 进行广角成像时观察到的 18 个脉络膜痣的位置映射到径向散射图上。为了进行比较，从 CEI 数据库中确定了 100 名连续的成人脉络膜痣患者。主要结局是脉络膜痣的大小、生长和分布情况。
儿童脉络膜痣的最大基底直径中位数为 1.6 毫米（范围为 0.4-4.2）。大多数脉络膜痣（75%）保持稳定，16%的脉络膜痣在随访时出现生长。平均增长率计算为 0.12 毫米/年（范围为 0.10-0.15）。在儿童期未发现恶变。所有与脉络膜痣相关的继发性改变（如玻璃膜疣、橙色素沉着和视网膜下积液）均少于成人（p<.05）。儿童脉络膜痣的位置明显比成人更靠后。儿童脉络膜痣距黄斑的中位数距离为 2.1 毫米（范围为 0.5-8.5），而成人脉络膜痣的距离为 5.1 毫米（范围为 0.4-16）（p<.0001）。
儿童脉络膜痣的发生和生长提示儿童期存在活跃的脉络膜痣发生。后极部的分布位置可能支持脉络膜黑素细胞移行和成熟的发育框架。
