ArticleEye (London, England)2026
Validation of MOLES score for small choroidal melanomas: impact of assuming enlargement for telemedicine in sizable lesions.
Article in Eye (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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4 authors.
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Abstract
backgroundThe MOLES scoring system was developed to help non-experts estimate the likelihood of malignancy in melanocytic choroidal tumours according to mushroom shape, orange pigment, large size, enlargement, and subretinal fluid. If only imaging is assessed, as in telemedicine, a choroidal melanoma (CM) may be scored as a naevus if subretinal fluid and orange pigment are not evident and if sequential imaging is not available. In such a telemedicine environment it might be safest to modify the MOLES score to assume lesion enlargement has occurred if the thickness and/or diameter exceed 3 mm or 7.5 mm, respectively.
methodsClinical records and multimodal imaging of patients with clinically diagnosed small CM (with no histopathological analysis) treated with ruthenium-106 (Ru-106) plaque brachytherapy were retrospectively reviewed. Sensitivity of the original and revised MOLES in estimating likelihood of malignancy were evaluated.
resultsThe cohort comprised 142 patients (mean age 60 ± 13.6 years) with small CM. Mean tumour thickness and largest basal diameter (LBD) were 1.9 ± 0.5 mm (range 0.4-2.5 mm) and 7.5 ± 1.9 mm (range 3.5-15 mm), respectively. The MOLES score was ≥3 in 97.9% and 100% of small CM according to the original and modified scoring systems, respectively. No cases had MOLES score <2, indicating that 100% of patients would have been referred for specialist assessment.
conclusionsThe revised MOLES score increases sensitivity in diagnosing CM from 97.9% to 100% and is therefore a useful aid to patient management.
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