Abstract
Purpose: :
To compare detection rates of subretinal fluid (SRF) and subretinal deposition (drusen, orange pigment) by spectral domain optical coherence tomography (SD-OCT) as compared to stereo color photos by trained observers in cases of indeterminate melanocytic lesions (IML) referred to the retina service at the VA Medical Center.
Methods: :
A retrospective case series of 10 consecutive patients (70 + 10 years, all Caucasian males) with indeterminate melanocytic lesions (small sized melanoma per the Collaborative Ocular Melanoma Study nomenclature, 5 - 16 mm LBD, 1-2.5 mm height) was investigated. Stereo color fundus images and SD-OCT images were independently reviewed by two fellowship trained academic retina specialists, masked to other patient information, for the presence of SRF, drusen, and orange pigment (stereo images only). Fischer’s exact test (p<0.05) was used to compare the detection rates by stereo images and SD-OCT.
Conclusions: :
SD-OCT provides a valuable adjunct to clinical examination for detection of SRF as well as drusenoid deposition in indeterminate melanocytic lesions. The findings on OCT combined with the clinical exam led to reclassification of 6 of 10 patients as having a small melanoma rather than a choroidal nevus but this clinical significance is unknown. Earlier detection of subretinal fluid with SD-OCT may lead to improved prognosis for these patients. Once validated in a larger number of patients, SD-OCT can be incorporated into diagnostic algorithms of these lesions.
Keywords: retina • tumors • imaging/image analysis: clinical