Fundus autofluorescence of choroidal nevus and melanoma.
BACKGROUND
To describe autofluorescence patterns of choroidal melanocytic lesions using the Heidelberg Retinal Angiograph 2 system (HRA2).


METHODS
20 patients with choroidal melanocytic lesions in the ocular fundus underwent ophthalmologic examination, fundus photography, autofluorescence and optical coherence tomography (OCT). Pathologic examination was performed on one enucleated eye with a large choroidal melanoma.


RESULTS
15 patients had choroidal nevi and 5 had malignant choroidal melanoma (1 small, 1 medium and 3 large tumours). Choroidal nevi did not show any characteristic autofluorescence pattern, although secondary retinal pigment epithelium (RPE) changes, such as drusen and pigment epithelium detachment, appeared faintly hyperautofluorescent in 2 patients. Only the small malignant choroidal melanomas had prominent orange pigmentation, although all melanomas had an intense confluent hyperautofluorescent signal over the lesions. Pathology of one large malignant melanoma revealed lipofuscin underlying RPE.


CONCLUSIONS
Most nevi did not have characteristic hyperautofluorescent features, but choroidal melanomas seemed to have a pattern of confluent hyperautofluorescence. Therefore, autofluorescence may be a useful non-invasive tool to assess lipofuscin in pigmented choroidal lesions, which may contribute to the diagnosis of malignancy. This hypothesis, however, remains to be confirmed in large prospective studies.
Lavinsky
Daniel
D
Vision Institute, Escola Paulista de Medicina, Universidade Federal de São Paulo, SP 04023-062, Brazil. lavinsky@via-rs.net
Belfort
Rubens N
RN
Navajas
Eduardo
E
Torres
Virginia
V
Martins
Maria Cristina
MC
Belfort
Rubens
R
D002830:Choroid Neoplasms / Q000175:diagnosis* / Q000473:pathology; D015353:Eye Enucleation; D005451:Fluorescein Angiography / Q000379:methods*; D006801:Humans; D008545:Melanoma / Q000175:diagnosis*; D009508:Nevus, Pigmented / Q000175:diagnosis* / Q000473:pathology; D010857:Pigment Epithelium of Eye / Q000473:pathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods