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Optical coherence tomography of retinal and choroidal tumors.

Say EA, Shah SU, Ferenczy S, Shields CL - J Ophthalmol (2011)

Bottom Line: In ocular oncology, OCT provides axial resolution to approximately 7 microns with cross-sectional images of the retina, delivering valuable information on the effects of intraocular tumors on the retinal architecture.Some effects include retinal edema, subretinal fluid, retinal atrophy, photoreceptor loss, outer retinal thinning, and retinal pigment epithelial detachment.Future improvements in image resolution and depth will allow better understanding of the mechanisms of visual loss, tumor growth, and tumor management.

View Article: PubMed Central - PubMed

Affiliation: Oncology Service, Wills Eye Institute, Thomas Jefferson University, Suite 1440, 840 Walnut Street, Philadelphia, PA 19107, USA.

ABSTRACT
Optical coherence tomography (OCT) has revolutionized the field of ophthalmology since its introduction 20 years ago. Originally intended primarily for retina specialists to image the macula, it has found its role in other subspecialties that include glaucoma, cornea, and ocular oncology. In ocular oncology, OCT provides axial resolution to approximately 7 microns with cross-sectional images of the retina, delivering valuable information on the effects of intraocular tumors on the retinal architecture. Some effects include retinal edema, subretinal fluid, retinal atrophy, photoreceptor loss, outer retinal thinning, and retinal pigment epithelial detachment. With more advanced technology, OCT now provides imaging deeper into the choroid using a technique called enhanced depth imaging. This allows characterization of the thickness and reflective quality of small (<3 mm thick) choroidal lesions including choroidal nevus and melanoma. Future improvements in image resolution and depth will allow better understanding of the mechanisms of visual loss, tumor growth, and tumor management.

No MeSH data available.


Related in: MedlinePlus

Choroidal nevus. (a) Amelanotic choroidal nevus with overlying RPE alterations and areas of RPE atrophy. (b) EDI OCT image shows both anterior and posterior margins of the lesion. There is gradual transition between the hyperreflective inner choroid and hyporeflective outer choroid. There is loss of choriocapillaris over the main lesion. Multifocal excrescences of the RPE are also present, suggestive of drusen.
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fig1: Choroidal nevus. (a) Amelanotic choroidal nevus with overlying RPE alterations and areas of RPE atrophy. (b) EDI OCT image shows both anterior and posterior margins of the lesion. There is gradual transition between the hyperreflective inner choroid and hyporeflective outer choroid. There is loss of choriocapillaris over the main lesion. Multifocal excrescences of the RPE are also present, suggestive of drusen.

Mentions: OCT features of choroidal nevus have been extensively documented but are limited mostly to its effects on the overlying retina and the anterior choroidal surface [8]. Shields and associates compared the frequency of retinal findings by clinical examination to OCT [15]. They found that OCT has a higher sensitivity than clinical examination in detection of overlying retinal edema (15% by OCT versus 3% by clinical examination), subretinal fluid (26% versus 16%), retinal thinning (22% versus 0%), and RPE detachment (12% versus 2%) [15]. OCT also enabled the examiners to characterize retinal edema (cystoid versus noncystoid) and determine the status of overlying photoreceptors [15]. These features are significant, since foveal edema and RPE detachment were found to be predictive of 3 or more lines of vision loss (RR = 22.16 and 9.02, resp.) and a final visual outcome worse than 20/200 (RR = 12.80 and 18.72, resp.) [16]. Overlying photoreceptor loss can also explain associated visual field defects in some patients. Findings localized to the RPE are also visualized readily by OCT. OCT evidence of overlying drusen manifests as small dome-shaped elevations at the level of the RPE/Bruch's membrane [15] (Figure 1). Nevus-related drusen are found in 41% of choroidal nevi imaged by OCT and are also visualized by ophthalmoscopy [15].


Optical coherence tomography of retinal and choroidal tumors.

Say EA, Shah SU, Ferenczy S, Shields CL - J Ophthalmol (2011)

Choroidal nevus. (a) Amelanotic choroidal nevus with overlying RPE alterations and areas of RPE atrophy. (b) EDI OCT image shows both anterior and posterior margins of the lesion. There is gradual transition between the hyperreflective inner choroid and hyporeflective outer choroid. There is loss of choriocapillaris over the main lesion. Multifocal excrescences of the RPE are also present, suggestive of drusen.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3139893&req=5

fig1: Choroidal nevus. (a) Amelanotic choroidal nevus with overlying RPE alterations and areas of RPE atrophy. (b) EDI OCT image shows both anterior and posterior margins of the lesion. There is gradual transition between the hyperreflective inner choroid and hyporeflective outer choroid. There is loss of choriocapillaris over the main lesion. Multifocal excrescences of the RPE are also present, suggestive of drusen.
Mentions: OCT features of choroidal nevus have been extensively documented but are limited mostly to its effects on the overlying retina and the anterior choroidal surface [8]. Shields and associates compared the frequency of retinal findings by clinical examination to OCT [15]. They found that OCT has a higher sensitivity than clinical examination in detection of overlying retinal edema (15% by OCT versus 3% by clinical examination), subretinal fluid (26% versus 16%), retinal thinning (22% versus 0%), and RPE detachment (12% versus 2%) [15]. OCT also enabled the examiners to characterize retinal edema (cystoid versus noncystoid) and determine the status of overlying photoreceptors [15]. These features are significant, since foveal edema and RPE detachment were found to be predictive of 3 or more lines of vision loss (RR = 22.16 and 9.02, resp.) and a final visual outcome worse than 20/200 (RR = 12.80 and 18.72, resp.) [16]. Overlying photoreceptor loss can also explain associated visual field defects in some patients. Findings localized to the RPE are also visualized readily by OCT. OCT evidence of overlying drusen manifests as small dome-shaped elevations at the level of the RPE/Bruch's membrane [15] (Figure 1). Nevus-related drusen are found in 41% of choroidal nevi imaged by OCT and are also visualized by ophthalmoscopy [15].

Bottom Line: In ocular oncology, OCT provides axial resolution to approximately 7 microns with cross-sectional images of the retina, delivering valuable information on the effects of intraocular tumors on the retinal architecture.Some effects include retinal edema, subretinal fluid, retinal atrophy, photoreceptor loss, outer retinal thinning, and retinal pigment epithelial detachment.Future improvements in image resolution and depth will allow better understanding of the mechanisms of visual loss, tumor growth, and tumor management.

View Article: PubMed Central - PubMed

Affiliation: Oncology Service, Wills Eye Institute, Thomas Jefferson University, Suite 1440, 840 Walnut Street, Philadelphia, PA 19107, USA.

ABSTRACT
Optical coherence tomography (OCT) has revolutionized the field of ophthalmology since its introduction 20 years ago. Originally intended primarily for retina specialists to image the macula, it has found its role in other subspecialties that include glaucoma, cornea, and ocular oncology. In ocular oncology, OCT provides axial resolution to approximately 7 microns with cross-sectional images of the retina, delivering valuable information on the effects of intraocular tumors on the retinal architecture. Some effects include retinal edema, subretinal fluid, retinal atrophy, photoreceptor loss, outer retinal thinning, and retinal pigment epithelial detachment. With more advanced technology, OCT now provides imaging deeper into the choroid using a technique called enhanced depth imaging. This allows characterization of the thickness and reflective quality of small (<3 mm thick) choroidal lesions including choroidal nevus and melanoma. Future improvements in image resolution and depth will allow better understanding of the mechanisms of visual loss, tumor growth, and tumor management.

No MeSH data available.


Related in: MedlinePlus