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Association between choroidal pigmentation and posterior uveal melanoma in a white population
  1. J W Harbour1,
  2. M A Brantley, Jr1,
  3. H Hollingsworth2,
  4. M Gordon1
  1. 1Department of Ophthalmology and Visual Sciences, Washington University, St Louis, Missouri, USA
  2. 2Programme in Occupational Therapy, Washington University, St Louis, Missouri, USA
  1. Correspondence to: J William Harbour Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, Box 8069, 660 S. Euclid Avenue, St Louis, MO 63110, USA;


Background/aims: It is well known that light skin pigmentation is a risk factor for cutaneous melanoma. The aim of this study was to investigate the analogous association between choroidal pigmentation and posterior uveal melanoma.

Methods: Cross sectional study of 65 consecutive patients diagnosed with posterior uveal melanoma (melanoma group) and 218 consecutive patients referred for general retinal evaluation (control group). All patients were white. A clinical grading system for estimating choroidal pigmentation was developed and histologically validated in seven patients.

Results: Melanoma patients with light iris colour were significantly more likely to have darker choroidal pigmentation than controls (p = 0.005). Darker choroidal pigmentation was associated histologically with increased density of choroidal melanocytes (p = 0.005).

Conclusions: Increased choroidal pigmentation, as a result of an increase in the density of pigmented choroidal melanocytes, is not protective but may actually be a risk factor for the development of posterior uveal melanoma in white patients. This finding may have implications for understanding the pathogenesis of uveal melanoma.

  • choroidal melanocytes
  • choroidal melanoma
  • choroidal pigmentation
  • uveal melanoma

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