June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Swept-source optical coherence tomography (SS-OCT) biomarkers for progression of suspicious choroidal lesions
Author Affiliations & Notes
  • Mary Munsell
    Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, United States
    Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Ines Lains
    Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, United States
    Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Rebecca Zeng
    Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, United States
    Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • John B Miller
    Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, United States
    Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Mary Munsell None; Ines Lains None; Rebecca Zeng None; John Miller Alcon, Allergan, Carl Zeiss, Sunovion, Genentech, Code C (Consultant/Contractor)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4684. doi:
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    • Get Citation

      Mary Munsell, Ines Lains, Rebecca Zeng, John B Miller; Swept-source optical coherence tomography (SS-OCT) biomarkers for progression of suspicious choroidal lesions. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4684.

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

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Abstract

Purpose : Assessing risk for progression of choroidal lesions to melanoma currently relies mostly on fundus examination and ultrasonography. Newer imaging modalities, such as swept-source optical coherence tomography (SS-OCT), may offer advantages in terms of resolution, but their role in assessing suspicious choroidal lesions has not been established. In this study, we aimed to identify baseline SS-OCT factors associated with lesion progression using a cohort with long clinical follow-up.

Methods : In this prospective longitudinal study, patients with pigmented choroidal lesions <3 mm in thickness underwent baseline SS-OCT (DRI Atlantis, Topcon; 12x9mm horizontal volume and 12-line radial scans), fundus photography, and ultrasound between 2014 and 2015. Imaging was repeated at follow-up visits. Charts were reviewed for clinical characteristics and ultrasonographic lesion thickness, both at baseline and follow-up. All SS-OCT scans were assessed by two independent graders based on predefined criteria, and lesion thickness and diameter were measured and averaged. The primary outcome was change in thickness from baseline based on ultrasound at most recent follow-up visit. A secondary outcome was dichotomous lesion progression, defined as melanoma diagnosis, lesion growth ≥0.5 mm/year, and/or lesion thickness ≥2 mm on last follow-up ultrasound. Linear and logistic models were used for analysis.

Results : We included a total of 70 patients. Over a median follow-up of 6.2 years, 5 were diagnosed with melanoma, 4 had lesion growth ≥0.5 mm/year, and 8 had lesion thickness ≥2 mm. Baseline lesion thickness on SS-OCT was significantly associated with change in thickness on ultrasound (p=0.006), but baseline ultrasound thickness was not (p=0.149). The presence of drusen, visibility of the scleral-choroidal interface, and ellipsoid zone disruption were also significantly associated with change in thickness. In a multivariable model, only scleral-choroidal interface visibility remained statistically significant (p=0.013). Lesion thickness on both SS-OCT (p=0.023) and ultrasound (p<0.0001) was significantly associated with dichotomous progression.

Conclusions : Baseline lesion thickness on SS-OCT, but not ultrasound, was significantly associated with increased change in thickness over the follow-up interval. SS-OCT may provide additional information relative to current techniques used to assess lesion risk.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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