Limitations of imaging choroidal tumors in vivo by optical coherence tomography.
BACKGROUND
Optical coherence tomography (OCT) produces two-dimensional cross-sectional images with a longitudinal resolution of 10 microns. Its capacity for imaging retinal structure has been shown in a variety of diseases. There are no reports on its capacity and limitations in imaging choriocapillary and choroidal structures.


METHODS
Twenty-two patients with the diagnosis of malignant melanoma of the choroid were submitted to OCT. We used a prototype and a commercial device, both with an 850-nm superluminescent diode with a band-width of 30 nm (reported longitudinal resolution 10 microns). The images were evaluated for retinal thickness, changes in retinal pigment epithelium, subretinal fluid accumulation and changes in choriocapillary or choroidal reflectivity.


RESULTS
Retinal edema and detachment found on biomicroscopic examination for fluorescein angiography was detected by OCT in all such cases. In 2 of 22 cases small retinal detachments were detected only by OCT. Tumor extension through the retinal pigment epithelium was not seen in this series, either by biomicroscopy or by OCT. The pattern of choroidal or choriocapillary reflectivity was nonspecifically lower than that of normal choroid, but did not yield any additional information about tumor histology. When normal retina was present, the OCT appearance of a malignant melanoma resembled that of normal choroid.


CONCLUSIONS
OCT may provide information about the retinal structure overlying prominent tumors and the extent of adjacent retinal detachment. In its present state of development, OCT is of little value in the differential diagnosis of choroidal tumors. Its potential value for the follow-up of shallow tumors needs further investigation.
Augenklinik und Poliklinik, Universitäts-Krankenhaus Eppendorf, Hamburg, Germany.
U
U
Schaudig
A
A
Hassenstein
A
A
Bernd
A
A
Walter
G
G
Richard
D000328:Adult; D000368:Aged; D002829:Choroid / Q000473:pathology*; D002830:Choroid Neoplasms / Q000175:diagnosis*; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D007368:Interferometry; D008027:Light; D008297:Male; D008545:Melanoma / Q000175:diagnosis*; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000473:pathology*; D012160:Retina / Q000473:pathology*; D012163:Retinal Detachment / Q000175:diagnosis; D014054:Tomography / Q000379:methods*