Objective: The aim of this study was to determine the sensitivity and specificity of the MOLES scoring system in differentiating choroidal melanomas from nevi according to Mushroom shape, Orange pigment, Large tumor size, Enlarging tumor, and Subretinal fluid (SRF). Methods: Color photographs, fundus-autofluorescence images, and optical coherence tomography of 222 melanocytic choroidal tumors were reviewed. Each MOLES feature was retrospectively scored between 0 and 2 and tumors categorized as “common nevus,” “low-risk nevus,” “high-risk nevus,” and “probable melanoma” according to the total score. MOLES scores were compared with the experts’ diagnosis of melanoma. Results: The MOLES scoring system indicated melanoma in all 81 tumors diagnosed as such by ocular oncologists (100% sensitivity) and nevus in 135 of 141 tumors given this diagnosis by these experts (95.7% specificity). Of the 6 tumors with discordant diagnoses, 4 had basal diameters exceeding 6 mm, all with SRF and/or orange pigment, and 2 small tumors showed either significant SRF with traces of orange pigment, or vice versa. Conclusions: The MOLES system for diagnosing melanocytic choroidal tumors compares well with expert diagnosis but needs to be evaluated when deployed by ophthalmologists and community optometrists in a wide variety of working environments.
Ocul Oncol Pathol

中文翻译：

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使用 MOLES 算法区分脉络膜痣和黑色素瘤：眼痣诊所的评估

目的：本研究的目的是确定 MOLES 评分系统根据蘑菇形状、橙色色素、大肿瘤尺寸、增大的肿瘤和视网膜下液 (SRF) 区分脉络膜黑色素瘤和痣的敏感性和特异性。方法：回顾了 222 例黑素细胞脉络膜肿瘤的彩色照片、眼底自发荧光图像和光学相干断层扫描。每个 MOLES 特征回顾性评分在 0 到 2 之间，根据总分将肿瘤分为“普通痣”、“低风险痣”、“高风险痣”和“可能的黑色素瘤”。将MOLES评分与专家对黑色素瘤的诊断进行比较。结果： MOLES 评分系统显示，由眼科肿瘤学家诊断的所有 81 个肿瘤中均存在黑色素瘤（敏感性 100%），而专家诊断的 141 个肿瘤中有 135 个肿瘤中存在痣（特异性 95.7%）。在 6 个诊断不一致的肿瘤中，4 个肿瘤基底直径超过 6 mm，均具有 SRF 和/或橙色色素，2 个小肿瘤显示显着的 SRF 并伴有橙色色素痕迹，反之亦然。结论：用于诊断黑素细胞脉络膜肿瘤的 MOLES 系统与专家诊断相比效果良好，但在眼科医生和社区验光师在各种工作环境中部署时需要进行评估。
眼肿瘤病理