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. 2023 Dec;11(4):104-112.
doi: 10.1007/s40135-023-00315-w. Epub 2023 Jul 19.

Conjunctival Nevus

Jaxon J Huang  1   2   3 , Elyana V T Locatelli  1   2   3 , Alberto Chocron  1   2   3 , Matthew R Camacho  1 , Sander Dubovy  1 , Carol L Karp  1 , Anat Galor  1   2   3
Affiliations

Conjunctival Nevus

Jaxon J Huang et al. Curr Ophthalmol Rep. 2023 Dec.

Abstract

Purpose of review: To provide an up-to-date review of the epidemiology, presentation, diagnosis, and treatment options for conjunctival nevi (CN).

Recent findings: Around 17.2%-42% of all conjunctival tumors have been found to be CN, which most frequently present in White individuals between the first to early third decade of life, with equal distribution between males and females. CN commonly occur in the interpalpebral bulbar conjunctiva with pigmentation ranging from amelanotic to dark. Diagnosis is typically made through slit lamp examination, visualized by a well circumscribed, variably elevated, variably pigmented, solitary lesion with clear cysts distributed throughout the pigment. In ambiguous cases, anterior segment optical coherence tomography (AS-OCT) can highlight the presence of sub-clinical cysts, whose presence points to a diagnosis of nevus. However, excisional biopsy with histopathology examination is the gold standard for identifying CN.

Summary: CN are benign, variably pigmented lesions. They are the most common of the conjunctival melanocytic tumors. Due to the extremely low risk of transformation to malignant melanoma (MM), CN are usually managed with routine observation and photo documentation.

Keywords: Conjunctival melanocytic tumor; Conjunctival melanoma; Conjunctival nevus; Malignant melanoma.

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Conflict of interest statement

Conflict of Interest The authors declare that they have no conflict of interest. The authors have no relevant financial or non-financial interests to disclose. The manuscript does not contain clinical studies or patient data.

Figures

Fig. 1
Fig. 1
(a) Slit lamp photo of an amelanotic nevus at the limbus. (b) Optical coherence tomography of a sub-clinical cyst (white arrow), favoring the diagnosis of nevus
Fig. 2
Fig. 2
(a) Slit lamp photo of a pigmented nevus at the limbus with a large adjacent cyst. (b) Optical coherence tomography with a large cyst (white arrow)
Fig. 3
Fig. 3
Slit lamp photo of a pigmented nevus near the limbus with small cysts within areas of pigmentation
Fig. 4
Fig. 4
Nests of nevus cells present within both the epithelium (arrows) and the substantia propria (asterisks), seen with (a) hematoxylin and eosin staining (× 200) and (b) Melan-A with red chromagen staining (× 200)
Fig. 5
Fig. 5
Slit lamp photo showing large, flat, blue-brown lesions on the inferior fornix diagnosed as blue nevi
Fig. 6
Fig. 6
(a) Slit lamp photo of a temporal pigmented nevus with a cyst (black arrow), also visualized on (b) optical coherence tomography (white arrow). (c) Photo of a nasal nevus with fairly uniform pigment and no cysts visualized on slit lamp. (d) However, on optical coherence tomography, cysts (white arrows) were visualized
Fig. 7
Fig. 7
Slit lamp photo of a flat, pigmented lesion consistent with primary acquired melanosis
Fig. 8
Fig. 8
Slit lamp photo of perilimbal pigmentation consistent with complexion associated melanosis
Fig. 9
Fig. 9
Slit lamp photo of a dark, irregular, raised lesion and perilimbal pigmentation consistent with malignant melanoma
Fig. 10
Fig. 10
Slit lamp photo of pigmentation in the episclera consistent with ocular melanocytosis
See this image and copyright information in PMC

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