Optical coherence tomography in the evaluation of retinal changes associated with suspicious choroidal melanocytic tumors.
OBJECTIVE
Subretinal fluid (SRF) is a strong risk factor for growth of choroidal melanocytic tumors. However, subtle SRF can be difficult to assess clinically and to distinguish from chronic retinal changes overlying a dormant lesion. This study investigates optical coherence tomography (OCT) in evaluating SRF in suspicious choroidal melanocytic tumors.


METHODS
Interventional case series.


METHODS
Review of 33 patients with untreated choroidal melanocytic tumors who underwent OCT for suspicion of subtle SRF. Fluorescein angiography was performed in 26 of the patients. The main outcome was tumor growth.


RESULTS
No retinal separation was found in 12 tumors, of which 1 (8%) grew on follow-up and 3 (25%) were treated. Chronic retinal changes (localized retinal separation with retinal atrophy or intraretinal cysts) were found in nine tumors: one (11%) grew on follow-up and none were treated. Active SRF (localized retinal separation with normal retinal appearance) was found in 12 tumors: 6 (50%) grew on follow-up, and 7 (58%) were treated. The active OCT pattern was associated with fluorescein angiography hotspots (P =.041), documented tumor growth (P =.033), and tumor treatment (P =.014), and inversely associated with drusen (P =.024), atrophic retinal pigment epithelium changes surrounding the tumor (P =.048), and intraretinal cysts by OCT (P =.002).


CONCLUSIONS
Optical coherence tomography is useful in distinguishing active subretinal fluid from chronic retinal changes overlying a choroidal melanocytic tumor. Optical coherence tomography findings may have predictive value in identifying tumors that are likely to grow and require treatment.
Espinoza
Gabriella
G
Ocular Oncology Service, Department of Ophthalmology and Visual Sciences and Barnes Retina Institute, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Rosenblatt
Brett
B
Harbour
J William
JW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D001826:Body Fluids; D002830:Choroid Neoplasms / Q000473:pathology*; D003560:Cysts / Q000175:diagnosis*; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000473:pathology*; D012160:Retina / Q000000981:diagnostic imaging / Q000473:pathology*; D012163:Retinal Detachment / Q000175:diagnosis*; D041623:Tomography, Optical Coherence / Q000379:methods*; D014463:Ultrasonography