Iris Nevi Is Distinguishable From Melanoma on Anterior Segment Fluorescein Angiography

Anterior segment fluorescein angiography (AS-FA) can be utilized to differentiate iris nevi from iris melanoma, according to a poster presented at the 2022 annual meeting of the American Academy of Ophthalmology (AAO), held in Chicago September 30 to October 3. 

To establish this, researchers identified and compared angiographic patterns between patients with iris melanoma (n=40) and patients with iris nevi (n=15). Demographic information, tumor characteristics and anterior segment fluorescein angiographic parameters (feeder vessels, intrinsic vessels, leakage, masking, and angiographic silence) were assessed.

The investigators report feeder vessels were present in 17 melanomas (43%) but were absent in nevi (P =.002). They observed intrinsic vessels in 33 iris melanomas (83%) and 5 iris nevi (33%) with a significant association of intrinsic vessels with malignancy (P =.001). 

Fluorescein leakage and masking were found in both iris melanoma and nevi without significant difference. Angiographic silence occurred in 3 nevi (20%) and was not observed in any melanoma (P =.017).