First Author: Z.Eldaly EGYPT
Co Author(s): M. Adel
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To evaluate the potential role of SS-OCT in assessing the architecture of common choroidal tumours and differentiating between them.
A prospective observational study was conducted in Alforsan Eye centre, Assiut, Egypt from January 2016 till November 2016.
Eighteen consecutive patients suffering from different choroidal tumours were included. All patients underwent complete ophthalmic history taking, slit lamp and fundus exam. All necessary ophthalmic investigations (including US, FFA and FAF) were done according to physician discern in addition to systemic work up to categorize the choroidal tumour. Subretinal fluid, ISOS junction and RPE changes, inner surface of the tumour, internal reflectivity and tumour effect on the surrounding choroid and underlying sclera were evaluated in each tumour. Maximum dimensions and depth of the tumour were measured if possible.
Eighteen eyes of 19 patients (10 males and 8 females) were included. Mean age was 47.62 ± 11.81 years (32-71 years). Melanotic choroidal naevus in 12 eyes, metastatic choroidal mass in 2 eyes, choroidal haemangioma in 1 eye, choroidal melanoma in 3 eyes and disc melanocytoma in 1 eye. Melanotic choroidal naevus had a smooth high reflective inner surface, surface drusen (4/12 cases) homogenous intermediate reflectivity and back-shadowing. 6 cases of melanotic naevus were located within the arcade, 3 peripapillary naevus and 3 extramacular naevus. Metastatic choroidal mass had a high reflective undulating inner surface with overlying subretinal fluid and heterogeneous intermediate reflectivity. Choroidal haemangioma had a smooth intermediate inner surface with overlying subretinal fluid and well-circumscribed heterogeneous intermediate reflectivity from surrounding choroid. Choroidal melanoma had elevated irregular high reflective inner surface with subretinal fluid and retinal cysts, disrupted ISOS and RPE, significant back-shadowing and indistinct outer boundaries. Disc melanocytoma had a lumpy high reflective inner surface with significant back-shadowing obscuring disc and RNFL architecture. Successful measurement of maximum dimension and depth was achieved in all choroidal naevi. Maximum dimension was 3034.54 ± 942 um. However, neither dimension of the tumours nor depth was measured successfully in other tumours.
SS-OCT provides an additive imaging modality in evaluating different choroidal tumour characteristics. Detailed information about tumour architecture and its effect on surrounding retina and choroid will pose a significant impact on understanding tumour pathology in vivo. In addition, SS-OCT allows close follow up and accurate measurement of high risk naevi for early subclinical malignant transformation.