First Author: M.Pellegrini ITALY
Co Author(s): F. Corvi G. Staurenghi
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To describe the imaging features of choroidal melanoma using swept source optical coherence tomography angiography (OCT-A) and evaluate its ability to display tumour intrinsic vasculature.
Retrospective observational case series conducted at the Eye Clinic, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, University of Milan.
Patients with choroidal melanoma underwent a complete ophthalmic evaluation, including best corrected visual acuity, colour fundus photography, B-scan ultrasound, fluorescein angiography (FA), indocyanine green angiography (ICGA) and swept source OCT-A with Zeiss prototype (PLEX Elite, Swept-Source OCT model 9000, Carl Zeiss Meditec, Inc, Dublin, CA).
Twenty-two eyes of 22 consecutive patients with choroidal melanoma were included in the study; 11 cases (50%) were treatment naïve. Three lesions (14%) were located at the macula, 14 (63%) between the macula and equator and 5 (23%) between the equator and the ora serrata. The mean tumour base and thickness were respectively 10.3 mm (range 5-15 mm) and 4.5 mm (range 1.5-8.9 mm). Seventeen lesions (77%) were dome shaped whereas 5 (23%) showed a mushroom configuration. Thirteen lesions (59%) were pigmented, 5 (23%) partially pigmented and 4 (18%) amelanotic. An exudative retinal detachment was detected in 13 eyes (59%). FA and ICGA disclosed intrinsic microvasculature of the tumour respectively in 4 (20%) and 22 (100%) cases whereas OCT-A detected microvasculature of choroidal melanoma in all cases. Specifically, intrinsic vasculature could be recognized in 14 eyes (64%) using the automated choroid segmentation, 16 eyes (73%) using the automated whole eye segmentation and in 22 eyes (100%) with fine manual adjustments of segmentation lines.
Swept source OCT-A represents a valid imaging technique in evaluating patients affected by choroidal melanomas. In our series OCT-A disclosed the intrinsic microvasculature of the tumour in all cases despite their size and position.