{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:57:19Z","timestamp":1793141839954,"version":"4.5.0"},"reference-count":32,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2020,5,21]],"date-time":"2020-05-21T00:00:00Z","timestamp":1590019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Purpose: To evaluate the MOLES system for identifying malignancy in melanocytic choroidal tumors in patients treated for choroidal melanoma. Methods: Records of 615 patients treated for choroidal melanoma between January 2017 and December 2019 were reviewed. Patients were excluded if iris and\/or ciliary body involvement (106 patients), inadequate fundus photography (26 patients), no images available for review (21 patients) and\/or treatment was not primary (11 patients). Demographic data and AJCC TNM Stage were collected. Color fundus and autofluorescence photographs (FAF), optical coherence tomography (OCT) and B-scan ultrasounds were prospectively reviewed. MOLES scores were assigned according to five criteria: mushroom shape, orange pigment, large size, enlarging tumor and subretinal fluid. Results: A total of 451 patients (mean age, 63.9 \u00b1 13.9 years) were included. At treatment, mean largest basal tumor diameter (LBD) and thickness were 10.3 \u00b1 2.8 mm (range, 3.0\u201323.0) and 4.3 mm (range, 1.0\u201317.0). All but one (0.2%) had MOLES scores of \u22653. Eighty-two patients were treated after surveillance lasting a mean of 1.5 years. Initially, most (63\/82; 76.8%) had a MOLES score \u2265 3. Importantly, none of the 451 tumors had a score of &lt;2, and as such, the MOLES protocol would have indicated referral to an ocular oncologist for 100% of patients. Conclusion: The MOLES scoring system is a sensitive (99.8%) tool for indicating malignancy in melanocytic choroidal tumors (MOLES \u2265 3). If the examining practitioner can recognize the five features suggestive of malignancy, MOLES is a safe tool to optimize referral of melanocytic choroidal tumors for specialist care.<\/jats:p>","DOI":"10.3390\/cancers12051311","type":"journal-article","created":{"date-parts":[[2020,5,21]],"date-time":"2020-05-21T11:31:18Z","timestamp":1590060678000},"page":"1311","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["The MOLES System for Planning Management of Melanocytic Choroidal Tumors: Is It Safe?"],"prefix":"10.3390","volume":"12","author":[{"given":"Kelsey A.","family":"Roelofs","sequence":"first","affiliation":[{"name":"Ocular Oncology Service, Moorfields Eye Hospital, London EC1V 2PD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roderick","family":"O\u2019Day","sequence":"additional","affiliation":[{"name":"Ocular Oncology Service, Moorfields Eye Hospital, London EC1V 2PD, UK"},{"name":"Ocular Oncology Clinic, Royal Victorian Eye and Ear Hospital, Melbourne VIC 3002, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9367-8395","authenticated-orcid":false,"given":"Lamis","family":"Al Harby","sequence":"additional","affiliation":[{"name":"Ocular Oncology Service, Moorfields Eye Hospital, London EC1V 2PD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit K.","family":"Arora","sequence":"additional","affiliation":[{"name":"Ocular Oncology Service, Moorfields Eye Hospital, London EC1V 2PD, UK"},{"name":"NIHR Biomedical Research Centre for Ophthalmology, University College London Institute of Ophthalmology, London EC1V 9EL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7793-160X","authenticated-orcid":false,"given":"Victoria M.L.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Ocular Oncology Service, Moorfields Eye Hospital, London EC1V 2PD, UK"},{"name":"NIHR Biomedical Research Centre for Ophthalmology, University College London Institute of Ophthalmology, London EC1V 9EL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1530-3824","authenticated-orcid":false,"given":"Mandeep S.","family":"Sagoo","sequence":"additional","affiliation":[{"name":"Ocular Oncology Service, Moorfields Eye Hospital, London EC1V 2PD, UK"},{"name":"NIHR Biomedical Research Centre for Ophthalmology, University College London Institute of Ophthalmology, London EC1V 9EL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertil","family":"Damato","sequence":"additional","affiliation":[{"name":"Ocular Oncology Service, Moorfields Eye Hospital, London EC1V 2PD, UK"},{"name":"Nuffield Laboratory of Ophthalmology, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1038\/sj.eye.6702276","article-title":"Accuracy of choroidal melanoma diagnosis by general ophthalmologists: A prospective study","volume":"21","author":"Khan","year":"2006","journal-title":"Eye"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1097\/00006982-200509000-00013","article-title":"Pseudomelanomas of the posterior uveal tract: The 2006 Taylor R. 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