Evaluation of choroidal tumors with optical coherence tomography: enhanced depth imaging and OCT-angiography features

Aim To describe the vascular features of choroidal tumors using enhanced depth imaging (EDI), optical coherence tomography (OCT), and OCT-angiography. Methods In this prospective study, we evaluated 116 Caucasian patients with choroidal tumors (60 eyes with choroidal nevi, 40 with choroidal melanoma, 6 with choroidal hemangioma, 2 with optic disc melanocytoma, 6 with choroidal osteoma, and 2 with retinal metastases). Patients underwent a complete ophthalmic examination including bulbar echography, EDI-OCT, OCT-angiography, and multicolor imaging. Sixteen patients also underwent fluorescein and indocyanine angiography. Results The left eye was more involved than the right eye. The mean tumor thickness was 1.23 +/- 0.17 mm in the 60 eyes with choroidal nevi; 2.75 +/- 0.83 mm in the 40 eyes with choroidal melanoma; 3.28 +/- 0.78 mm in the 6 eyes with retinal angioma; 2.02 +/- 0.001 mm in the 2 eyes with optic disc melanocytoma; 2.40 +/- 0.31 mm in the 6 eyes with choroidal osteoma; and last, 3.49 +/- 0.001 mm in the 2 eyes with retinal metastases. OCTangiography showed: (i) a lack of blood flow in the outer retinal layer (ORL) and a normal choroid capillary layer in choroidal nevi and optic disc melanocytomas; (ii) a lack of blood flow in the ORL of choroidal metastases; and (iii) a dense irregular vascular network in the ORL and choroid capillary layers of choroidal melanomas, choroidal hemangiomas, and choroidal osteomas. Conclusions OCT-angiography is a noninvasive reliable method with which to evaluate the vascularization of small choroidal tumors and may improve the diagnosis of these tumors.