Congenital divided melanocytic nevi of the upper and lower eyelid are rare pigmented changes of the eyelids. These processes are also known as "kissing nevi," "panda nevi," and "split ocular nevi," and were first described by Fuchs in 1919. About 120 cases have been described in the literature so far. Congenital melanocytic nevi are either present at birth (small nevi are already found in about 1% of neonates) or manifest predominantly during the first decade of life. These rare melanocytic changes of the eyelids should be controlled regularly, as malignant transformation can occur. The actual incidence of malignant transformation is highly variable in the literature, ranging from 2 to 40% depending on the duration of follow-up, with an average of 14% for the whole lifetime. Moreover, nevi of the eyelids may be considered cosmetically disturbing and cause functional problems. Therapeutic removal (dermabrasion, cryotherapy, laser therapy, and surgical excision with ophthalmoplastic reconstruction) is rarely medically indicated due to the low risk of malignant transformation. Removal can be performed in cases of secondary amblyopia in ptosis, compression of the lacrimal point, epiphora, or cosmetic desire. Treatment becomes necessary not only in case of suspicious manifestation or impairment of eyelid function, but it also helps to avoid possible bullying at school among children and is recommended at age 4 to 6 (before school age).

Kongenitale geteilte melanozytäre Nävi (CMN) des Ober- und Unterlids sind seltene pigmentierte Veränderungen der Augenlider. Diese Muttermale sind auch als „kissing nevi“, „panda nevi“, „split ocular nevi“ bekannt und wurden erstmals 1919 von Fuchs beschrieben. Aus der Literatur sind bisher etwa 120 solcher Fälle bekannt. CMN sind entweder seit der Geburt vorhanden (kleine Nävi finden sich bereits bei ca. 1 % der Neugeborenen), oder sie manifestieren sich überwiegend im ersten Lebensjahrzehnt. Diese seltene melanozytäre Veränderung der Augenlider sollte regelmäßig kontrolliert werden, denn gemäß der Literatur kann es zu einer malignen Entartung kommen. Die tatsächliche Inzidenz dafür ist jedoch sehr variabel und reicht von 2 bis 40 %, je nach Dauer des Follow-up, mit durchschnittlich 14 % auf die gesamte Lebensdauer. Zudem können CMN an den Augenlidern als kosmetisch störend empfunden werden und zu funktionellen Problemen des Auges führen. Eine therapeutische Entfernung mittels Dermabrasion, Kryotherapie, Laserbehandlung oder chirurgische Exzision mit ophthalmoplastischer Deckung ist aufgrund des geringen Entartungsrisikos selten medizinisch indiziert. Sie kann aber bei sekundärer Amblyopie bei Ptosis, Kompression der Puncta lacrimalia, Epiphora oder basierend auf einem kosmetischen Wunsch durchgeführt werden. Notwendig wird die Therapie hingegen bei einer suspekten Erscheinungsform oder Beeinträchtigung der Lidfunktion und um mögliche Hänseleien und grausamen Spott bei Kindern zu vermeiden.

Abteilung für Allgemeine Ophthalmologie und Pädiatrische Ophthalmologie Medizinische Universität Lublin Lublin Polen

Abteilung für onkologische Chirurgie Multidisziplinäres M Copernicus Woiwodschaftszentrum für Onkologie und Traumatologie Lodz Polen

Augenklinik Stadtspital Zürich Zürich Schweiz

Centrum für Integrierte Onkologie Bonn Düsseldorf Köln Köln Deutschland

Klinik für Augenheilkunde Abteilung für öffentliche Gesundheit Universität Neapel Federico 2 Neapel Italien

Klinik für Augenheilkunde Universitätskrankenhaus Ostrava Ostrava Tschechien

Medizinische Fakultät Universität Ostrava Ostrava Tschechien

Wojskowy Instytut Medyczny Klinika Okulistyki Warszawa Polen

Zentrum für Augenheilkunde Medizinische Fakultät und Uniklinik Köln Universität zu Köln Kerpener Straße 62 50937 Köln Deutschland

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