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Comparative study of flare photometry in patients with choroidal malignant melanoma and choroidal nevus

Introduction: Malignant intraocular tumors are associated with an increase in the aqueous flare, caused by alterations of the blood-ocular barriers through various mechanisms. Several studies have demonstrated an ocular flare increase using flare photometry in eyes with benign and malignant tumors. Purpose: To evaluate flare photometry as an adjunct method in the differential diagnosis of choroidal malignant melanoma and choroidal nevus comparing to normal control eyes. Methods: Eyes with melanoma and nevus were diagnosed by indirect binocular ophthalmoscopy and/or ultrasound were evaluated. The fellow normal eyes were used as a control. In all subject and control eyes flare photometry was performed using the Laser Flare Meter (FC 500, Kowa), under mydriasis. Statistical analysis was done using the Wilcoxon, Mann-Whitney, and Spearman tests. Results: Thirty-one eyes with malignant melanoma and 18 eyes with nevus were evaluated. The flare photometry average in the eyes with malignant melanoma was 17.1 ph/ms and in the control fellow eyes it was 4.06 ph/ms. In eyes with choroidal nevus the flare photometry average was 6.12 ph/ms and in the control fellow eyes it was 4.47 ph/ms. The flare photometry was higher in eyes with malignant melanoma and nevus than in the fellow normal eyes (p<0.001 and p<0.01). Comparing the eyes with malignant melanoma and nevus, flare photometry was significantly higher in eyes with malignant melanoma (p<0.001). There was a positive correlation between the tumor thickness and flare photometry (r=0.47). Conclusion: Flare photometry is a helpful tool in the differential diagnosis of malignant melanoma and choroidal nevus.

Melanoma; Choroid neoplasms; Nevi and melanomas; Lasers; Photometry; Comparative study; Differential diagnosis; Blood-aqueous barrier


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