Abstract
Purpose :
Optical coherence tomography angiography (OCT-A) is a non-invasive imaging technique that allows dye-free detection of chorioretinal blood flow, and may serve as a supplementary imaging tool for ocular tumors. This study reports OCT-A features of rare benign intraretinal tumors.
Methods :
We describe OCT-A (Topcon DRI OCT Triton, Japan) findings in 3 patients with benign intraocular tumors; choroidal osteoma, combined hamartoma of the retina and retinal pigment epithelium (RPE) and optic nerve melanocytoma.
Results :
Case 1: A 30-year-old female with undifferentiated connective tissue dysplasia presented after an incidental lesion was noted in the left eye following an episode of anterior uveitis. Her fundus examination showed a small, solitary, amelanotic choroidal lesion inferior to the optic nerve with a few overlying drusen and associated subretinal fluid (SRF) encroaching the fovea. The patient was diagnosed with choroidal osteoma and associated choroidal neovascularization. SRF resolved with anti-VEGF injections. Post-treatment OCT-A images of the osteoma revealed good vessel density in both superficial and deep capillary plexuses and a few hyporeflective tubular areas in the outer retina. The osteoma was seen as a hyporeflective region in the choriocapillaris with scattered hyperreflective areas.
Case 2: An 8-year-old male with combined hamartoma of the retina and RPE presented after failing a vision test. Fundus examination of the right eye showed macular thickening with gray discoloration, surface wrinkling, and a fibrotic stalk-like appearance. OCT-A imaging revealed disorganized vessels in the superior plexus, decreased vessel density in the deep plexus, absent foveal avascular zone and intraretinal cysts throughout the tumor.
Case 3: A 57-year-old female presented with decreased vision in the right eye. Fundus examination showed a charcoal grey hyperpigmented lesion extending superiorly to the optic disc with feathery margins. The patient was diagnosed with optic nerve melanocytoma and central serous chorioretinopathy causing recurrent non-foveal SRF. OCT-A of the optic nerve showed choroidal areas void of signal at the location of the tumor possibly due to masking by the pigment and increased vascular heterogeneity in both superficial and deep capillary plexuses (more pronounced in the deep plexus).
Conclusions :
OCT-A may be a valuable supplementary tool for imaging benign ocular tumors.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.