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Swept-source optical coherence tomography imaging of choroidal tumors

Session Details

Session Title: Miscellaneous

Session Date/Time: Saturday 13/09/2014 | 11:00-13:00

Paper Time: 11:08

Venue: Boulevard E

First Author: : A.Filloy Rius SPAIN

Co Author(s): :    S. Jordan   J.M. Caminal           

Abstract Details

Purpose:

To describe the Swept-Source optical coherence tomography (SS-OCT) features of a series of choroidal tumors and correlate them with the findings in funduscopy, ultrasonography (US) and fundus autofluorescence (FAF) imaging.

Setting:

A group of 29 patients clinically diagnosed with different choroidal tumors in our ocular oncology unit.

Methods:

Structured as a prospective observational case series in a group of patients with posterior pole choroidal tumors with a maximum diameter of 12 millimeters. All patients underwent clinical fundus photography, US and FAF as well as SS-OCT. The assessed characteristics were maximum tumor diameter, maximum tumor thickness, tumor inner structure and outline, visibility of choroidal layers and inner sclera, and presence of drusen, retinal pigment epihelial (RPE) changes, lipofucsin, subretinal fluid (SRF) and intraretinal fluid (IRF).

Results:

The study has included 32 tumors from 32 eyes corresponding to 29 patients, comprising 17 choridal nevi, 7 lesions with risk factor for growth, 4 choroidal melanomas one of them non pigmented and 4 circumscribed choroidal hemangiomas. SS-OCT allowed an accurate measurement of the tumor’s maximum diameter in every case including those undetectable by US (<1mm). In most cases of pigmented tumors the sclerochoroidal interface was not recognizable through SS-OCT probably due to the molecules of pigment blocking the laser beam. Choroidal nevi displayed a compact and regular structure with in most cases a preserved choriocapillaris overlying the tumor. Choroidal melanomas showed a more irregular inner structure, in one case with intratumoral images we identified as intratumoral vessels. Choroidal hemangiomas have a regular sponge-like vascular pattern well differentiated from melanomas and nevi, with a compacted but preserved choriocapillaris. The presence of lipofucsin, subretinal fluid and RPE atrophy detected on funduscopy and FAF was also correlated with the findings in SS-OCT. SSOCT provided as well with a simultaneous view of the vitreous-retina-choroid-sclera structure along 12 mm-long sections allowing assessment of the changes in proximal and distal choroid and retina such as presence of drusen, SRF, and IRF.

Conclusions:

SS-OCT enables obtaining long cross-sectional views of choroidal tumors allowing an accurate measurement and assessment of their associated structural anomalies, as well as a view of their inner structure. Visualization of the inner sclera remains as an issue to be solved when working with pigmented tumors. This is a small case-series whose results should be confirmed by larger studies, but the results obtained suggest that SS-OCT might play a role in differential diagnosis, follow up an monitorization after treatment in the choroidal tumors of the posterior pole.

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