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S. Garnier, L. Kodjikian, J. D. Grange; Final Results of the Cohort of Small Undetermined Melanocytic Choroidal Tumours Analyzed by OCT. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5235.
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The diagnosis of undefined small choroidal melanocytic tumours is difficult. Nevi are frequent and benign while small melanomas are rare and malignant tumors. Controversy between prompt (iatrogenicity) or deferred (treatment lateness) divides ophthalmologists.The presence of subretinal fluid (SRF) is a strong risk factor for tumor growth. Optical Coherence Tomography (OCT) is a new imagery technique that is a powerful way to evidence SRF. We aim to evaluate diagnostic value of OCT in case of undetermined small tumours under observation.
Small undetermined melanocytic tumours of the choroid which are recently diagnosed are included during 12 months in a prospective cohort of 50 patients. OCT analysis is specifically performed to look at one single OCT sign: SRF presence. Main outcome is tumour size changes. Retrospective statistical analysis occurs after 12 months of mean follow-up.
In this serie, 17/50 (35%) tumours are SRF-associated. Topographic modalities of SRF seem to be ruled by tumour situation and the gravity. In the SRF-free tumours group, no significant growth is observed. In contrast, growth can be observed for some SRF-associated tumours. After statistical analysis of these two comparable groups, there is a significant mean growth difference, but this mean difference is not clinically significant. Furthermore, 6/7 (85%) tumours treated among this period were initially SRF-associated tumours.
Great diagnostic sensitivity of SRF seen in OCT and easiness using OCT make this imagery technique finally seems to have an interest in complement of fundus examination, ultrasonography, photography and angiography when evaluating small choroidal melanocytic tumours. After OCT examination, some SRF-associated tumours should be controlled more frequently. OCT also might represent a screening tool.
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