Abstract
Purpose:
To describe optical coherence tomography (OCT) features of retinal and choroidal tumors using the en face technique.
Methods:
Prospective observational case series. We included in our study 66 eyes of 65 patients with retinal or choroidal tumors. Patients underwent ophthalmoscopic examination, fundus photography, A and B-scan ultrasonography, SD-OCT and en face OCT. All the OCT images were obtained by CIRRUS OCT (Carl Zeiss, Meditec) with the 512x128 macular cube acquisition. For each retinal and choroidal lesion qualitative characteristics (tumor outline, reflectivity and/or shadowing of choroidal layers) were assessed.
Results:
In all cases, en face OCT was able to identify the tumor from the surrounding normal choroid, allowing to determine the tumor area. En face OCT scan is able to detect structural and morphological details. In our cases, en face OCT imaging of choroidal nevi shows a well demarcated, sub-retinal pigment epithelium (RPE) hyporeflectivity area, while images of choroidal melanomas show a sub-RPE hyporeflective area with irregular and hyper-reflective edge due to vascular tissue. Choroidal hemangioma shows a circumscribed sub-RPE hyperreflective area surrounded by a hyporeflective ring. Choroidal metastasis often show an irregular hyporeflective area, but in some cases we observed a well-demarcated round shape. Choroidal osteoma is well visualized as an irregular hyporeflective area. We evaluated en face OCT morphological features of retinal astrocytoma and RPE adenoma. Even small choroidal lesions nondetectable by ultrasonography can be objectively identified and measured by this new technique.
Conclusions:
En face OCT could be a useful diagnostic modality for imaging the retina and RPE overlying a choroidal lesion. This diagnostic approach may provide some information about peculiar details of choroidal and retinal lesions which cannot be imaged with other techniques and it will probably represent an useful tool to monitor the changes during follow-up.
Keywords: 744 tumors •
452 choroid •
688 retina