Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Ophthalmology, University of Bonn, Bonn, Germany.
Sci Rep. 2024 Nov 18;14(1):28534. doi: 10.1038/s41598-024-78692-w.
Choroidal nevi are common benign melanocytic lesions often incidentally found during routine ophthalmic examinations. Patients with choroidal nevi are frequently referred to ocular oncology centers to differentiate these from choroidal melanoma and to exclude a malignant transformation which rarely occurs. However, this causes a high workload for referral centers and may delay diagnosis and treatment of patients with potentially severe conditions. To overcome this, the MOLES score was previously developed which may empower non-specialists to differentiate choroidal nevi from melanoma. In this retrospective study, the performance of the MOLES score was assessed in 695 patients with choroidal nevi and 53 with choroidal melanoma. With a specificity of 96% (choroidal nevi) and a sensitivity of 100% (melanoma) the MOLES score was highly successful in differentiating choroidal nevi from melanoma and may offer great potential to optimize monitoring and referral decisions, and for teleophthalmology applications. Furthermore, the TFSOM-DIM score using risk factors for determining tumor progression was applied and showed a good correlation with MOLES. A complementary use of MOLES and TFSOM-DIM may be beneficial for clinical routine: MOLES for screening by non-experts with limited diagnostic tools and TFSOM-DIM in a referral setting to counsel also regarding potential transformation.
脉络膜痣是常见的良性黑色素细胞病变，常在眼科常规检查中偶然发现。脉络膜痣患者常被转诊至眼肿瘤科，以将其与脉络膜黑色素瘤区分开来，并排除罕见的恶变。然而，这给转诊中心带来了很大的工作量，并可能延误对有潜在严重情况的患者的诊断和治疗。为了克服这一问题，之前开发了 MOLES 评分，它可以使非专家能够区分脉络膜痣和黑色素瘤。在这项回顾性研究中，评估了 MOLES 评分在 695 例脉络膜痣和 53 例脉络膜黑色素瘤患者中的表现。MOLES 评分具有 96%（脉络膜痣）的特异性和 100%（黑色素瘤）的敏感性，成功地将脉络膜痣与黑色素瘤区分开来，可能为优化监测和转诊决策以及远程眼科应用提供巨大潜力。此外，还应用了 TFSOM-DIM 评分，使用肿瘤进展的危险因素来判断肿瘤，结果显示与 MOLES 具有良好的相关性。MOLES 和 TFSOM-DIM 的互补使用可能有益于临床常规：MOLES 可用于非专家使用有限的诊断工具进行筛查，而 TFSOM-DIM 则可用于转诊，以评估潜在的恶变。
