Melanosis (eye)

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Melanosis of the eye is a term for flat, blotchy and unclearly circumscribed pigmentations of the anterior segment of the eye that are not shared with other entities such as B. nevi can be assigned. Their pigmentation varies greatly from colorless to dark brown. Depending on the type and location, a distinction is made between congenital, ethnic and other (primary) melanoses, as well as acquired melanoses. In addition, pigmentation of the anterior segment of the eye also occurs with substance deposits (e.g. certain drugs) and after inflammation (post-inflammatory hyperpigmentation).

Pathology, Epidemiology and Therapy

So-called ethnic melanoses occur almost regularly in people with dark skin types, usually bilaterally (on both eyes), sometimes symmetrically. The frequency of melanosis oculi in the white population is given as 38 per 100,000 and in the dark-skinned population as 14 per 100,000. Significantly higher values ​​are estimated for Asians. The acquired melanoses, on the other hand, tend to affect fair-skinned middle-aged people. The exact names and delimitations of the various melanoses of the eye have been redefined over and over again in the past decades and there is still no final, uniformly recognized classification. It is only certain that congenital (congenital) melanoses are considered to be low-risk (melanosis oculi) or completely harmless (ethnic melanoses) with regard to the potential for degeneration.

With regard to acquired melanosis (PAM), the doctrines differ widely in terms of frequency and risk of degeneration. While some researchers see the risk of degeneration of acquired melanoses at up to 50%, others describe a prevalence of acquired melanoses of up to 36% of the population. With an incidence of about 1 / 1,000,000 per year for malignant melanoma of the anterior segment, this would mean a negligibly low risk of degeneration of the acquired melanoses. However, all the figures published so far are very contradictory and do not give a clear picture. Most researchers are therefore of the opinion that all acquired melanoses should be considered generally risky until a final research into this disease has been carried out, and it is recommended by ophthalmological societies that they be checked at regular intervals by an ophthalmologist. Changes, large or otherwise suspicious findings are usually removed surgically, since it is assumed that melanoses with cellular atypia have a particularly high risk of degeneration.

Diagnosis and management of ocular melanosis is made more difficult by the fact that to date there are no clear clinical criteria for differentiating between congenital, ethnic and acquired melanoses, nor is it possible to differentiate between non-melanoma pigmentations of the eye in the context of ophthalmological examinations. A reliable differential diagnosis is only possible for specially trained pathologists .

Web links

Individual evidence

  1. ↑ B. Ehall, G. Langmann: Congenital ocular melanosis. In: Spectrum of Ophthalmology. 8, 1994, pp. 192-194. doi: 10.1007 / BF03163707
  2. ↑ LH Sobin, C. Witter child: TNM Classification of Malignant Tumors. 6th edition. Wiley-Liss, New York 2002.
  3. ↑ Peter Gloor, George Alexandrakis: Clinical Characterization of Primary Acquired Melanosis. In: Investigative Ophthalmology & Visual Science. July 1995, Vol. 36, No. 8th.
  4. ↑ R. Folberg, IW McLean, LE Zimmerman: Primary acquired melanosis of the conjunctiva. In: Hum Pathol . 1985; 16, pp. 129-135.
  5. ↑ Bertil Damato et al: Conjunctival melanoma and melanosis: a reappraisal of terminology, classification and staging. In: Clinical and Experimental Ophthalmology. 2008; 36, pp. 786-795. doi: 10.1111 / j.1442-9071.2008.01888.x .
  6. ↑ M. Sugiura, KA Colby, MC Mihm Jr et al .: Low-risk and highrisk histologic features in conjunctival primary acquired melanosis with atypia: clinicopathologic analysis of 29 cases. In: Am J Surg Pathol . 2007; 31, pp. 185-192.
  7. ↑ CL Shields, JA Shields: Conjunctival primary acquired melanosis and melanoma: tales, fairy tales, and facts. In: Ophthal Plast Reconstr Surg. 2009 May-Jun; 25 (3), pp. 167-172.
  8. ↑ H. Wüstemeyer include: tumors of the conjunctiva. ( Memento of the original from December 16, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Accessed May 26th @1@ 2Template: Webachiv / IABot / www.uniklinik-essen.de
  9. ↑ M. Sugiura, KA Colby, MC Mihm Jr et al .: Low-risk and highrisk histologic features in conjunctival primary acquired melanosis with atypia: clinicopathologic analysis of 29 cases. In: Am J Surg Pathol. 2007; 31, pp. 185-192.