Lentz P Connor, Qureshi Muhammad B, Xu Timothy T, White Launia J, Olsen Timothy W, Pulido Jose S, Dalvin Lauren A
Mayo Clinic Alix School of Medicine, Jacksonville, FL, USA.
Department of Ophthalmology, Henry Ford Health System, Detroit, MI, USA.
Eye (Lond). 2025 Jun 19. doi: 10.1038/s41433-025-03889-w.
BACKGROUND/OBJECTIVES: Choroidal nevus necessitates regular monitoring due to its potential for malignant transformation. We identified features associated with lost to follow-up (LTFU), delayed follow-up (DFU), and appropriate follow-up (AFU) in choroidal nevus patients.
SUBJECTS/METHODS: This retrospective cohort study analysed 825 adults diagnosed with choroidal nevus between January 1, 2006, and December 31, 2015, in Olmsted County, Minnesota. Patient demographics, tumour features, and clinical outcomes were assessed according to follow-up status.
Among the patients, 82 (9.9%) were LTFU, 317 (38.4%) had DFU, and 426 (51.6%) had AFU. Comparing groups (LTFU vs. DFU vs. AFU), LTFU patients were younger (mean age 44.5 vs. 53.3 vs. 59.7 years, p < 0.001) and primarily diagnosed by optometrists (64.6% vs. 64.4% vs. 41.1%, p < 0.001) on routine visits (56.1% vs. 69.7% vs. 45.8%, p < 0.001). They had lower Charlson comorbidity index (0.4 vs. 0.5 vs. 0.7, p = 0.005) and less systemic cancer history (9.5% vs. 15.7% vs. 22.7%, p = 0.013). LTFU and DFU had better visual acuity (>20/50) compared to AFU (93.9% vs. 94.6% vs. 88.5%, p = 0.019). AFU had larger tumour dimensions (basal diameter: 2.5 mm vs. 2.3 mm vs. 2.8 mm, p = 0.003; thickness: 0.1 mm vs. 0.1 mm vs. 0.2 mm, p < 0.001). More LTFU patients had a mean initial recommended follow-up time of 12 months compared to DFU and AFU (80.5% vs. 78.9% vs. 74.2%, p < 0.001).
Factors associated with LTFU in choroidal nevus patients include younger age, lower comorbidity index, absence of cancer history, optometrist diagnosis, routine visit diagnosis, better visual acuity, less suspicious tumour features, and longer follow-up recommendation.
背景/目的：脉络膜痣因其有恶变的可能，需要定期监测。我们确定了脉络膜痣患者失访（LTFU）、随访延迟（DFU）和适当随访（AFU）相关的特征。
受试者/方法：这项回顾性队列研究分析了2006年1月1日至2015年12月31日期间在明尼苏达州奥尔姆斯特德县诊断为脉络膜痣的825名成年人。根据随访状态评估患者的人口统计学特征、肿瘤特征和临床结局。
在这些患者中，82人（9.9%）失访，317人（38.4%）随访延迟，426人（51.6%）进行了适当随访。比较各组（LTFU组与DFU组与AFU组），失访患者更年轻（平均年龄44.5岁对53.3岁对59.7岁，p<0.001），主要由验光师在常规就诊时诊断（64.6%对64.4%对41.1%，p<0.001）（56.1%对69.7%对45.8%，p<0.001）。他们的查尔森合并症指数较低（0.4对0.5对0.7，p = 0.005），全身癌症病史较少（9.5%对15.7%对22.7%，p = 0.013）。与适当随访的患者相比，失访和随访延迟的患者视力更好（>20/50）（93.9%对94.6%对88.5%，p = 0.019）。适当随访的患者肿瘤尺寸更大（基底直径：2.5毫米对2.3毫米对2.8毫米，p = 0.003；厚度：0.1毫米对0.1毫米对0.2毫米，p<0.001）。与随访延迟和适当随访的患者相比，更多失访患者的初始推荐随访时间为12个月（80.5%对78.9%对74.2%，p<0.001）。
脉络膜痣患者失访相关因素包括年龄较小、合并症指数较低、无癌症病史、验光师诊断、常规就诊诊断、视力较好、肿瘤特征可疑性较低以及随访推荐时间较长。
