Clinical imaging and high-resolution ultrasonography in melanocytoma management.
OBJECTIVE
To demonstrate the utility of high resolution 20 MHz ophthalmic ultrasound in serial follow-up of optic nerve head melanocytoma patients.


METHODS
This study is a retrospective review of 30 patients with melanocytoma of the optic nerve head studied with echography. All patients were evaluated with standard ophthalmic A-scan and B-scan ultrasonography and 10 (33%) underwent high-resolution ultrasound.


RESULTS
Sixty-two percent (62%) of patients had dome-shaped lesions on ultrasound, twenty-eight percent (28%) presented with mild elevations. The maximum elevation of any lesion was 2.6 mm. The vast majority (89%) of lesions had medium or high internal reflectivity and 89% demonstrated avascularity. Mean follow-up for all patients was nearly 7 years. High-resolution ultrasound enabled enhanced accuracy for detection of lesion dimensions and documentation of growth and possible malignant transformation.


CONCLUSIONS
In this study, we demonstrate a new and important role for the use of ultrasound in this disease as a complementary tool in identifying and following patients with high-risk growth characteristics. These tumor characteristics can be accurately detected with 10 MHz ultrasound in conjunction with standardized A-scan and better differentiated with the 20 MHz technology. Use of these modalities can aid in distinguishing the melanocytomas that grow from choroidal melanomas and can prevent unnecessary treatments.
Gologorsky
Daniel
D
Dartmouth Medical School, Hanover, New Hampshire, USA.
Schefler
Amy C
AC
Ehlies
Fiona J
FJ
Raskauskas
Paul A
PA
Pina
Yolanda
Y
Williams
Basil K
BK
Murray
Timothy G
TG