July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Diagnostic evaluation of optical coherence tomography angiography and fundus autofluorescence in bilateral diffuse uveal melanocytic proliferation
Author Affiliations & Notes
  • Noriyasu Hashida
    Dept of Ophthalmology, Osaka University Graduate School of Medicine, Suita, OSAKA, Japan
  • Akihiko Shiraki
    Dept of Ophthalmology, Osaka University Graduate School of Medicine, Suita, OSAKA, Japan
  • Andrew Winegarner
    Dept of Ophthalmology, Osaka University Graduate School of Medicine, Suita, OSAKA, Japan
  • Okihiro Nishi
    Jinshikai Medical Foundation, Nishi Eye Hospital, Suita, Japan
  • Yutaro Nishi
    Jinshikai Medical Foundation, Nishi Eye Hospital, Suita, Japan
  • Kazuichi Maruyama
    Dept of Ophthalmology, Osaka University Graduate School of Medicine, Suita, OSAKA, Japan
  • Hirokazu Sakaguchi
    Dept of Ophthalmology, Osaka University Graduate School of Medicine, Suita, OSAKA, Japan
  • Kohji Nishida
    Dept of Ophthalmology, Osaka University Graduate School of Medicine, Suita, OSAKA, Japan
  • Footnotes
    Commercial Relationships   Noriyasu Hashida, None; Akihiko Shiraki, None; Andrew Winegarner, None; Okihiro Nishi, None; Yutaro Nishi, None; Kazuichi Maruyama, None; Hirokazu Sakaguchi, None; Kohji Nishida, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 3639. doi:
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      Noriyasu Hashida, Akihiko Shiraki, Andrew Winegarner, Okihiro Nishi, Yutaro Nishi, Kazuichi Maruyama, Hirokazu Sakaguchi, Kohji Nishida; Diagnostic evaluation of optical coherence tomography angiography and fundus autofluorescence in bilateral diffuse uveal melanocytic proliferation. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3639.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the utility of optical coherence tomography angiography (OCTA) in visualizing the choroidal vasculature in bilateral diffuse uveal melanocytic proliferation (BDUMP), so as to investigate pathophysiology and also aid in diagnosis. Additionally, to recommend autofluorescence (AF) over traditional angiography for purposes of noninvasive diagnosis.

Methods : We investigated 3 cases of BDUMP, one of which presented with iris cysts which has only been recorded as such once before, in scientific literature. Conventional ophthalmic examinations and swept-source optical coherence tomography (SS-OCT) was performed to evaluate disease progressions. We used AF examination using a scanning laser ophthalmoscope (Optos, Optos plc, Scotland) to diagnose all three cases and investigated its diagnostic utility over classical fluorescein angiography. We also performed optical coherence tomography angiography (OCTA) (DRI OCT Triton, Topcon, Japan) on two of the cases for the evaluation of choroidal vasculature.

Results : Ophthalmoscopic examinations revealed reddish oval patches within the vascular arcades in each patient. SS-OCT showed thickening and thinning of the RPE, as well as a serous retinal detachment. AF was successfully used to diagnose all three cases regardless of etiology. AF examinations revealed diagnostic giraffe sign, intervening areas of increasing and decreasing AF, indicating BDUMP. OCTA revealed decreased vasculature in the choroidal layer in the two cases. OCTA examinations could also provide a novel way to directly visualize the choroidal vasculature damages, which are the primary site of the BDUMP lesions.

Conclusions : AF accomplished the same diagnostic precision while remaining non-invasive. Also we were able to use AF to diagnose all three cases ranging from extremely rare iris cysts to a more conventional presentation, indicating its utility regardless of etiology. OCTA findings might be potentially elucidative regarding the pathophysiology at the choroidal layer, where BDUMP lesions primarily exist. Given the limited number of recorded BDUMP cases and relatively unknown pathophysiology, OCTA may prove to be invaluable in visualizing disease progression.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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