Purpose Diagnosis of iris melanoma is challenging as no clear cut differentiating points exists for differentiation between iris naevi and melanoma. On the basis of our and others experience of iris tumors, an “iris melanoma module” was developed at LUMC in 1997 which included important clinical and UBM features of iris melanoma to diagnose and differentiate between iris naevi and ‐melanoma.This study is to identify important clinical and UBM variables predictive of diagnosing iris melanoma.
Methods Between January 1997 and December 2007, total 117 patients were seen with suspected iris melanocytic tumors and the iris melanoma module is filled in all these patients. On the basis of the module score for each patient, decision was made whether to treat or observe the patient. We analyzed all these patients on the basis of follow‐up and current status that whether the management strategy of these patients’ iris tumors on the basis of module was right.
Results 37 Patients were treated with plaque radiation (32%), 15 patients had excision or enucleation (13%), whereas in 65 patients lesions were observed with periodic follow‐up (55%). The follow‐up period is 2‐12 years. Of the 65 lesions observed for growth only 6(9%) showed growth. Most of the lesions which were excised proved to be the iris melanoma. All the variables of iris melanoma module were also analysed using the univariate and multivariate analysis.
Conclusion Clinical and UBM features of the iris tumors included in iris melanoma module appear to enable clinicians to differentiate reasonably well between probable malignant melanoma, for which prompt treatment is appropriate, and benign naevi, for which observation with periodic follow‐up is the good management option.