title: [Fundus fluorescein angiography in metastatic choroidal carcinomas and differentiating metastatic choroidal carcinomas from primary choroidal melanomas].
abstract: OBJECTIVE
  To investigate the characteristics of fundus fluorescein angiography (FFA) in metastatic choroidal carcinomas and determine the value of FFA in differentiating metastatic choroidal carcinomas from primary choroidal melanomas.
  
  
  METHODS
  It was a retrospective case series. The retrospective analysis of clinical data and FFA findings was performed in 23 eyes of 22 patients with metastatic choroidal carcinomas and 31 eyes of 31 patients with primary choroidal melanomas as the control.
  
  
  RESULTS
  Ocular fundus findings of metastatic choroidal carcinomas were divided into three types: solitary flat (tumor thickness less than 3 mm), solitary elevated (tumor thickness more than 3 mm) or diffuse type. FFA of the three types showed hypofluorescence during the arterial phase and progressive hyperfluorescence during the subsequent phases. The border of the lesions revealed retinal capillary dilation during the arteriovenous phase and persistent pinpoint leakage throughout the angiogram. Retinal capillary dilation and pinpoint leakage were more frequently presented in the solitary flat type. Simultaneous visualization of retinal and tumor circulation (the so called double circulation) was more frequently presented in the solitary elevated type. Pinpoint leakage could be detected in 17 (73.91%) eyes of metastatic choroidal carcinomas and in 5 (16.13%) eyes of primary choroidal melanomas. The difference between the visibility of pinpoint leakage in metastatic choroidal carcinomas and primary choroidal melanomas was statistically significant (P = 0.0000). When pinpoint leakage of FFA was used to differentiate metastatic choroidal carcinomas from primary choroidal melanomas, the sensitivity, specificity, accuracy, positive and negative predictive values were 73.91%, 83.87%, 79.63%, 77.27%, 81.25% respectively.
  
  
  CONCLUSIONS
  FFA is helpful for the diagnosis of metastatic choroidal carcinomas. Pinpoint leakage on the border of lesions has some value in differentiating metastatic choroidal carcinomas from primary choroidal melanomas.
authors.affiliation: Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai 200031, China. lilei@medmail.com.cn
authors.forename: Lei
authors.initials: L
authors.lastname: Li
authors.forename: Wen-Ji
authors.initials: WJ
authors.lastname: Wang
authors.forename: Rong-Jia
authors.initials: RJ
authors.lastname: Chen
authors.forename: Jiang
authors.initials: J
authors.lastname: Qian
authors.forename: Chuan-Qi
authors.initials: CQ
authors.lastname: Luo
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Zhang
authors.forename: Ying
authors.initials: Y
authors.lastname: Shen
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Ye
authors.forename: Qiao-Yun
authors.initials: QY
authors.lastname: Gao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging*; D002830:Choroid Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D003937:Diagnosis, Differential; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011859:Radiography; D012189:Retrospective Studies; D055815:Young Adult