There appears to be no significant association between the presence of ocular lesions and dysplastic nevi; but, patients with dysplastic nevi have a higher risk for cutaneous and secondary melanomas and may be considered for routine ophthalmic examination, according to study findings published in Dermatologic Therapy.
Researchers examined the eyes of 110 patients with multiple atypical nevi (mean age, 38±15 years) and 1 or more histopathologically proven dysplastic nevus. Examination findings were compared with an age- and skin type-matched control population (n=110) with a dysplastic nevi or melanoma diagnosis (mean age, 38±16 years). The investigators looked for the existence of any pigmented and/or melanocytic lesion in the eye of each participant.
No difference was found between the case and control group in terms of intense ultraviolet exposure (14.5% vs 11.8%, respectively; P >.05). Approximately 14.5% of patients in the dysplastic nevi study group had a history of melanoma vs no patients in the control group.
A total of 63 (57.3%) had 1 or more dysplastic nevi but did not fulfill the criteria for a diagnosis of dysplastic nevus syndrome (DNS). The researchers observed a similar frequency of conjunctival nevi, iris nevi, choroidal nevi, and conjunctival-acquired melanosis in both groups. The study group had a higher frequency of iris freckles, while complexion-associated conjunctival hyperpigmentation was observed more frequently in the control arm (P <.05). At 6-month follow up, no difference was found for changes in lesion size, color, or surface features.
Limitations of the study included the performance of only a single ophthalmic examination of the patients, the relatively short follow-up period of 6 months, and the small number of participants in each group.
Although the study did not reveal an increased risk for ocular lesions in patients with dysplastic nevi, the researchers concluded that they “still recommend considering ophthalmic examination at least in the cases of DNS with additional high risk factors for melanoma at this point.”
Karaarslan I, Yagcı A, Acar A, et al. Is it necessary to perform eye examination for patients with cutaneous atypical nevi? Published online November 3, 2020. Dermatol Ther. doi:10.1111/dth.14503