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Chromosomal aberrations, cytomorphology, nuclear BAP1 expression and circulating tumour cells (CTC) were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Markers of poor prognosis, including monosomy 3, 8q gain, loss of BAP1 expression, and the presence of CTC, were detected in tumours as small as 3\u20134\u2009mm in diameter and 1\u20131.5\u2009mm in thickness. In the cytogenetically analysed subset, monosomy\u20093 was observed in 23% (41\/175), 8q gain in 32% (23\/72) and 6q aberrations in 13% (9\/71); loss of nuclear BAP1 was seen in 22% (19\/88); and CTC were detected in 50% (22\/44). There was a strong association between tumour size and the number of clinical risk factors for lesion growth, such as subretinal fluid, orange pigment and acoustic hollowness on ultrasound, whereas these clinical features did not correlate with markers for poor prognosis. Monosomy of chromosome 3, gain of 8q, loss of 1p, gain or loss of 6q, gain or loss of 8p, loss of BAP1 expression, and cytomorphology were associated with worse survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Aggressive traits are common in small UM, including those &lt;10\u2009mm\n                      <jats:sup>3<\/jats:sup>\n                      in volume. Clinical risk factors traditionally used for assessing nevus growth appear more closely related to lesion size than metastatic potential. These findings underscore the importance of identifying novel clinical markers for metastatic risk.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.17582","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T11:13:45Z","timestamp":1755774825000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Metastatic potential of small posterior uveal melanomas"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9401-8911","authenticated-orcid":false,"given":"Gustav","family":"St\u00e5lhammar","sequence":"first","affiliation":[{"name":"Division of Eye and Vision, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"},{"name":"Ocular Oncology Service, St. Erik Eye Hospital  Stockholm Sweden"},{"name":"St. Erik Ophthalmic Pathology Laboratory, St. Erik Eye Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Kalirai","sequence":"additional","affiliation":[{"name":"Liverpool Ocular Oncology Research Group, Department of Eye and Vision Science, University of Liverpool  Liverpool UK"},{"name":"Liverpool Clinical Laboratories, NHS University Hospitals of Liverpool Group  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah E.","family":"Coupland","sequence":"additional","affiliation":[{"name":"Liverpool Ocular Oncology Research Group, Department of Eye and Vision Science, University of Liverpool  Liverpool UK"},{"name":"Liverpool Clinical Laboratories, NHS University Hospitals of Liverpool Group  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Grisanti","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Medical Center Schleswig\u2010Holstein  Luebeck Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svenja Rebecca","family":"Sonntag","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Medical Center Schleswig\u2010Holstein  Luebeck Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayseguel","family":"Tura","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Medical Center Schleswig\u2010Holstein  Luebeck Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Eleuteri","sequence":"additional","affiliation":[{"name":"Research and Innovation Department, NHS University Hospitals of Liverpool Group  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rumana N.","family":"Hussain","sequence":"additional","affiliation":[{"name":"Liverpool Ocular Oncology Research Group, Department of Eye and Vision Science, University of Liverpool  Liverpool UK"},{"name":"Liverpool Ocular Oncology Centre, NHS University Hospitals of Liverpool Group  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heinrich","family":"Heimann","sequence":"additional","affiliation":[{"name":"Liverpool Ocular Oncology Research Group, Department of Eye and Vision Science, University of Liverpool  Liverpool UK"},{"name":"Liverpool Ocular Oncology Centre, NHS University Hospitals of Liverpool Group  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Coud\u00e9 Adam","sequence":"additional","affiliation":[{"name":"Division of Eye and Vision, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","unstructured":"Al Harby L. 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