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W. Einbock, P. Wiedemann; Fundus Autofluorescence Imaging and High Resolution Optical Coherence Tomography of Melanocytic Tumors. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5132.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the different pattern of fundus autofluorescence imaging and their correlation documented by optical coherence tomography in melanocytic tumors.
In 25 patients affected by choroidal melanocytic tumor we performed fundus autofluorescence (FAF) and optical coherence tomography (OCT) with the confocal scanning laser ophthalmoscope (spectralis HRA+OCT, Heidelberg Engineering, Germany) following a standard protocol. The appearance of retinal tissue on the OCT scans was compared with the autofluorescent pattern, the fundus photography and ultrasound thickness measurement.
18 patients had choroidal nevi and 7 had malignant choroidal melanoma diagnosed. 7 flat pigmented choroidal nevi did not have characteristic hyperautofluorescent features and showed only slide changes in the retinal pigment epithelium (RPE) layer without disturbances of the well defined band structure of normal tissue and no thickness in ultrasound. 11 choroidal nevi with secondary RPE changes like drusen and RPE detachment appeared faintly hyperfluorescent and OCT detected RPE cell invasion into internal retinal layers as well as subretinal fluid and intraretinal splitting. Tumor thickness in ultrasound was less than 3 mm. Malignant choroidal melanomas showed typical increased confluent FAF correlated to the orange pigment and revealed lipofuscin. Serous retinal detachment was observed in all patients with choroidal melanoma. 5 cases showed also abnormal intraretinal structures, intraretinal splitting overlaying the lesion. Tumor thickness in ultrasound was more than 3 mm.
Imaging of FAF and OCT can document secondary retinal changes associated with choroidal lesions. These changes were observed in all patients with choroidal melanoma. Therefore, FA and OCT may be a useful non-invasive tool, which may contribute to the diagnosis of malignancy. To confirm our outcomes further large studies should be performed.
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