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Jason P. Brinton, Nicholas S. Leslein, Randall E. Verdick, H. Culver Boldt, Wallace L. Alward; IR Transillumination Videography In The Evaluation Of Intraocular Tumors. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4540.
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Tumors of the posterior iris, ciliary body & adjacent peripheralretina are among the most difficult intraocular lesions to diagnoseand follow. Ocular ultrasound is an excellent tool in evaluatingthese lesions but has several limitations. We describe the useof infrared transillumination videography (IR-T) as a complimentaryimaging modality for the evaluation & ongoing managementof these lesions.
A Javelin 18-108mm f2.5 macro lens is attached to a DonpishaCCD video camera mounted next to a slit lamp. The patient ispositioned at the slit lamp chinrest 12cm from the lens. Theroom is darkened & a Finhoff transilluminator is held incontact against an area of anesthetized conjunctiva.
From 1991 to 2010, 46 patients at the University of Iowa underwentIR-T to evaluate ciliary body masses. Twenty of 46 studies demonstratedthe entire boundaries of a lesion. Tumor dimensions on IR-Tcompared favorably with dimensions on ultrasound and gross pathology.Image #1: A 44-yo was referred for an enlarging darkly pigmentedscleral mass measuring 2.9x3.0mm. Image #2: IR-T showed a larger8x6mm oval plaque extending over an area of the ciliary body.Brachytherapy based on IR-T dimensions was performed; the tumorhas remained involuted on follow-up for 6 years.
IR-T is a highly useful modality to define & follow themargins of intraocular tumors involving the ciliary body, iris& peripheral retina. IR-T is easily & rapidly performed,comfortable for the patient & requires inexpensive technologythat is widely available. Limitations arise in cases of minimallypigmented lesions & when other pigmented material such ashemorrhage obscures lesion borders.
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