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T. M. Grippo, S. Natesh, K. J. Chin, P. T. Finger; Clinical Correlation of Fundus Auto Fluorescence and Optical Coherence Tomography/Scanning Laser Ophthalmoscope Imaging for Choroidal Metastasis. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5234.
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© ARVO (1962-2015); The Authors (2016-present)
To correlate the clinical characteristics (CC), fundus autofluorescence (FAF) and optical coherence tomography/scanning laser ophthalmoscope (OCT/SLO) characteristics of choroidal metastatic tumors.
Retrospective chart review of patients diagnosed with choroidal metastatic tumors who underwent CC, FAF, OCT/SLO imaging.
Clinical characteristics of 10 tumors, in 10 eyes of 9 consecutive patients were included. All patients underwent detailed clinical evaluation and fundus autofluorescence pictures using Topcon fundus camera (excitation filter 580 nm and barrier filter 695 nm) and OCT/SLO (Ophthalmic Technologies Incorporated) imaging studies. Patient age ranged from 41-81 years and 6 were male. One patient had bilateral choroidal metastases. All female patients had breast primaries, while males had primary tumors in the lung (n=2), kidney (n=1) and colon (n=1). Two patients had unknown primaries. Eight of 9 (89%) patients had synchronous systemic metastasis (lung, liver, bone) at the time of diagnosis with choroidal metastases. All 10 tumors were amelanotic and 8 exhibited pigmentation on their surface. Ultrasound imaging revealed a mean tumor height of 1.8 mm (range 0.9 to 7.2). The renal cell carcinoma metastasis was the largest. No extrascleral extension, drusen or orange pigmentation was seen. Fundus Autofluorescent Imaging showed hyperfluorescence corresponding to focal surface pigmentation and subretinal fluid. The tumor-margins were hypo fluorescent with dots of granularity. Optical Coherence Tomography revealed patterns of elevated retinal pigment epithelium (RPE), hyper-reflective RPE-thickening, serous retinal detachments and anterior displacement of the photoreceptor layer (hyporeflective spaces). Structural retinal changes included atrophy as well as intra and subretinal hyper-reflective deposits. Areas of FAF corresponded to RPE thickening and subretinal fluid. RPE folds/undulations correlated with retinochoroidal folds clinically.
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