Enhanced Depth Imaging Optical Coherence Tomography of Small Choroidal Melanoma Comparison With Choroidal Nevus

被引:97
作者
Shields, Carol L. [1 ]
Kaliki, Swathi [1 ]
Rojanaporn, Duangnate [1 ]
Ferenczy, Sandor R. [1 ]
Shields, Jerry A. [1 ]
机构
[1] Thomas Jefferson Univ, Ocular Oncol Serv, Wills Eye Inst, Philadelphia, PA 19107 USA
关键词
CENTRAL SEROUS CHORIORETINOPATHY; MELANOCYTIC TUMORS; GROWTH;
D O I
10.1001/archophthalmol.2012.1135
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Objective: To evaluate characteristics of small choroidal melanoma using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT). Design: Retrospective comparative analysis. Results: Of 37 eyes with small choroidal melanoma imaged using EDI-OCT, the mean tumor thickness was 1025 mu m by EDI-OCT compared with 2300 mu m by ultrasonography. By EDI-OCT, choroidal features included optical shadowing in 36 (100%) and overlying choriocapillaris thinning in 37 (100%). Outer retinal features included shaggy photoreceptors in 18 (49%), as well as absence (structural loss) of photoreceptors in 9 (24%), inner segment-outer segment junction in 24 (65%), external limiting membrane in 16 (43%), outer nuclear layer in 6 (16%), and outer plexiform layer in 4 (11%). Inner retinal features included irregularity of inner nuclear layer in 3 (8%), inner plexiform layer in 3 (8%), ganglion cell layer in 3 (8%), and nerve fiber layer in 2 (5%). Also identified were subretinal fluid in 34 (92%), subretinal lipofuscin deposition in 35 (95%), and intraretinal edema in 6 (16%). Using EDI-OCT, a comparison with similar-sized choroidal nevus revealed that small choroidal melanoma showed increased tumor thickness, subretinal fluid, subretinal lipofuscin deposition, and retinal pigment epithelium atrophy. Statistically significant EDI-OCT features for small choroidal melanoma included intraretinal edema (P=.003), shaggy photoreceptors or loss of photoreceptors (P=.005), loss of external limiting membrane (P=.008), loss of inner segment-outer segment junction (P=.02), irregularity of inner plexiform layer (P=.04), and irregularity of ganglion cell layer (P=.04) (t test and chi(2) test). Shaggy photoreceptors were found overlying small choroidal melanoma in 18 (49%) but were not observed overlying choroidal nevus (P <.001). Conclusions: Small choroidal melanoma tumor thickness was overestimated by 55% on ultrasonography compared with EDI-OCT. The EDI-OCT features of small choroidal melanoma compared with choroidal nevus include increased tumor thickness, subretinal fluid, subretinal lipofuscin deposition, and retinal irregularities, including shaggy photoreceptors.
引用
收藏
页码:850 / 856
页数:7
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