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Euiyong Kweon, Jaysun Frisch, Peter Hovland; Enhanced Depth Imaging Optical Coherence Tomography of Tumors of the Retina and Choroid: Comparison to B-scan ultrasonography. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4231. doi: https://doi.org/.
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To evaluate the characteristics of choroidal nevus, choroidal melanoma, metastatic lesions, and congenital hypertrophy of the retinal pigment epithelium (CHRPE) using the enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT), with a comparison to the B-scan ultrasound (BUS) findings.
A retrospective observational study design was used to evaluate characteristics of retinal and choroidal tumors using spectral-domain OCT. 40 sequential patients who presented to an ocular oncology practice were selected based on a posterior location of the lesions in question; this allowed for EDI-OCT imaging and BUS. EDI-OCT was performed with the Heidelberg Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany) using a custom scan image acquisition protocol of up to 13 raster lines of 9 mm image length. Ultrasound was performed with an I-cubed instrument in most cases.
EDI-OCT appears to yield greater anatomic detail and better thickness measurements in tumors of less than 2 mm thickness when compared to BUS. EDI-OCT is not able to create full-thickness imaging in lesions greater than 2 mm; yet in these lesions the technique has utility in that it can identify the location of the lesion (retina or choroid), as well as associated characteristic changes of the surrounding tissues (subretinal fluid, retinal edema, photoreceptor changes). EDI-OCT can detect tumor growth under subretinal fluid; as the components of fluid v. tumor are better distinguished than by BUS.
Imaging of choroidal and retinal tumors with EDI-OCT show superior measurement of certain tumor characteristics compared with ultrasonography. The clinical utility of this modality is emerging; this presentation demonstrates the usefulness of EDI-OCT in distinguishing suspicious nevi from small melanoma and CHRPE, detecting tumor re-growth along the treatment margin, and demonstrating retinal vs. choroid tumor location.
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