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Autofluorescence of metastatic choroidal tumor.

Ishida T, Ohno-Matsui K, Kaneko Y, Tobita H, Hayashi K, Shimada N, Mochizuki M - Int Ophthalmol (2008)

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.

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Metastatic choroidal carcinomas are the most common intraocular neoplasms ; diagnosis is made by ophthalmoscopic, fluorescein angiographic (FA), and indocyanine green angiographic (IA) findings together with a history of cancer especially of the breasts and lungs... A 72-year-old woman was referred for metamorphopsia when using her left eye... She did not report having breast cancer or other malignancies... Initially, her BCVA was 1.2 OU... The left fundus showed a dome-shaped, creamy choroidal tumor superior to the macula (Fig.  3)... This would explain the absence of fluorescence by both FA and AF in this area... However, the nasal area still showed hyperfluorescent dots by FA and hypofluorescent dots by AF, suggesting that the tumor was still perfused in this area but that the RPE cells did not contain lipofuscin... After radiation in case 2, the AF pattern was the reverse of the FA pattern; yellowish patches were hyperfluorescent by FA and hypofluorescent by AF, reflecting a dysfunction of the RPE over the tumor... An increase in the AF signal has been reported in other intraocular tumors; an intense AF signal was reported in eyes with a choroidal melanoma, and a histopathological study of the enucleated eye revealed hyperautofluorescent deposits within the RPE and macrophages overlying the melanoma... Cytoplasmic lipofuscin granules have been demonstrated in breast tissue obtained before chemotherapy and radiation... Light microscopic examinations of the excised mammary tissues from our case did not detect any autofluorescent lipofuscin pigment in the tissue... After radiation, the released lipofuscin from necrotic tumor cells might have been taken up by the RPE cells and macrophages overlying the tumor, and this accumulated lipofuscin might have been manifested as the intense AF signal... Although further studies are necessary, noninvasive AF might be clinically useful for diagnosis as well as the choice of therapy type.

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Ophthalmic findings in case 2. (a) Left fundus shows a creamy choroidal tumor superior to the macula. (b, c) Fluorescein angiograms showing granular hyperfluorescence along the margin of the tumor; late phase (c) shows diffuse hyperfluorescence. (d) Optical coherence tomographic scan along the line in (a), showing a dome-like elevation of the retina and RPE–choriocapillaris complex and surrounding retinal detachment
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Fig3: Ophthalmic findings in case 2. (a) Left fundus shows a creamy choroidal tumor superior to the macula. (b, c) Fluorescein angiograms showing granular hyperfluorescence along the margin of the tumor; late phase (c) shows diffuse hyperfluorescence. (d) Optical coherence tomographic scan along the line in (a), showing a dome-like elevation of the retina and RPE–choriocapillaris complex and surrounding retinal detachment

Mentions: A 72-year-old woman was referred for metamorphopsia when using her left eye. She did not report having breast cancer or other malignancies. Initially, her BCVA was 1.2 OU. The left fundus showed a dome-shaped, creamy choroidal tumor superior to the macula (Fig. 3). FA showed granular hyperfluorescence along the margins of the tumor, and OCT showed a dome-shaped elevation of the retina attached to the RPE–choriocapillaris complex and a surrounding RD. AF was not performed because the equipment was not available.Fig. 3


Autofluorescence of metastatic choroidal tumor.

Ishida T, Ohno-Matsui K, Kaneko Y, Tobita H, Hayashi K, Shimada N, Mochizuki M - Int Ophthalmol (2008)

Ophthalmic findings in case 2. (a) Left fundus shows a creamy choroidal tumor superior to the macula. (b, c) Fluorescein angiograms showing granular hyperfluorescence along the margin of the tumor; late phase (c) shows diffuse hyperfluorescence. (d) Optical coherence tomographic scan along the line in (a), showing a dome-like elevation of the retina and RPE–choriocapillaris complex and surrounding retinal detachment
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Related In: Results  -  Collection

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Fig3: Ophthalmic findings in case 2. (a) Left fundus shows a creamy choroidal tumor superior to the macula. (b, c) Fluorescein angiograms showing granular hyperfluorescence along the margin of the tumor; late phase (c) shows diffuse hyperfluorescence. (d) Optical coherence tomographic scan along the line in (a), showing a dome-like elevation of the retina and RPE–choriocapillaris complex and surrounding retinal detachment
Mentions: A 72-year-old woman was referred for metamorphopsia when using her left eye. She did not report having breast cancer or other malignancies. Initially, her BCVA was 1.2 OU. The left fundus showed a dome-shaped, creamy choroidal tumor superior to the macula (Fig. 3). FA showed granular hyperfluorescence along the margins of the tumor, and OCT showed a dome-shaped elevation of the retina attached to the RPE–choriocapillaris complex and a surrounding RD. AF was not performed because the equipment was not available.Fig. 3

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Metastatic choroidal carcinomas are the most common intraocular neoplasms ; diagnosis is made by ophthalmoscopic, fluorescein angiographic (FA), and indocyanine green angiographic (IA) findings together with a history of cancer especially of the breasts and lungs... A 72-year-old woman was referred for metamorphopsia when using her left eye... She did not report having breast cancer or other malignancies... Initially, her BCVA was 1.2 OU... The left fundus showed a dome-shaped, creamy choroidal tumor superior to the macula (Fig.  3)... This would explain the absence of fluorescence by both FA and AF in this area... However, the nasal area still showed hyperfluorescent dots by FA and hypofluorescent dots by AF, suggesting that the tumor was still perfused in this area but that the RPE cells did not contain lipofuscin... After radiation in case 2, the AF pattern was the reverse of the FA pattern; yellowish patches were hyperfluorescent by FA and hypofluorescent by AF, reflecting a dysfunction of the RPE over the tumor... An increase in the AF signal has been reported in other intraocular tumors; an intense AF signal was reported in eyes with a choroidal melanoma, and a histopathological study of the enucleated eye revealed hyperautofluorescent deposits within the RPE and macrophages overlying the melanoma... Cytoplasmic lipofuscin granules have been demonstrated in breast tissue obtained before chemotherapy and radiation... Light microscopic examinations of the excised mammary tissues from our case did not detect any autofluorescent lipofuscin pigment in the tissue... After radiation, the released lipofuscin from necrotic tumor cells might have been taken up by the RPE cells and macrophages overlying the tumor, and this accumulated lipofuscin might have been manifested as the intense AF signal... Although further studies are necessary, noninvasive AF might be clinically useful for diagnosis as well as the choice of therapy type.

Show MeSH
Related in: MedlinePlus