title: Enhanced depth imaging optical coherence tomography of choroidal metastasis in 14 eyes.
abstract: OBJECTIVE
  To describe the imaging features of choroidal metastasis using enhanced depth imaging optical coherence tomography (EDI-OCT).
  
  
  METHODS
  This retrospective observational case series included 31 eyes with choroidal metastasis. Spectral domain EDI-OCT was performed using Heidelberg Spectralis HRA + OCT. The main outcome measures were imaging features by EDI-OCT.
  
  
  RESULTS
  Of 31 eyes with choroidal metastasis imaged with EDI-OCT, 14 (45%) eyes displayed image detail suitable for study. The metastasis originated from carcinoma of the breast (n = 7, 50%), lung (n = 5, 36%), pancreas (n = 1, 7%), and thyroid gland (n = 1, 7%). The mean tumor basal diameter was 6.4 mm, and mean thickness was 2.3 mm by B-scan ultrasonography. The tumor location was submacular in 6 (43%) eyes and extramacular in 8 (57%) eyes. By EDI-OCT, the mean tumor thickness was 987 μm. The most salient EDI-OCT features of the metastasis included anterior compression/obliteration of the overlying choriocapillaris (n = 13, 93%), an irregular (lumpy bumpy) anterior contour (n = 9, 64%), and posterior shadowing (n = 12, 86%). Overlying retinal pigment epithelial abnormalities were noted (n = 11, 78%). Outer retinal features included structural loss of the interdigitation of the cone outer segment tips (n = 9, 64%), the ellipsoid portion of photoreceptors (n = 8, 57%), external limiting membrane (n = 4, 29%), outer nuclear layer (n = 1, 7%), and outer plexiform layer (n = 1, 7%). The inner retinal layers (inner nuclear layer to nerve fiber layer) were normal. Subretinal fluid (n = 11, 79%), subretinal lipofuscin pigment (n = 1, 7%), and intraretinal edema (n = 2, 14%) were identified.
  
  
  CONCLUSIONS
  The EDI-OCT of choroidal metastasis shows a characteristic lumpy bumpy anterior tumor surface and outer retinal layer disruption with preservation of inner retinal layers.
authors.affiliation: Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania. Dr. Al-Dahmash is now at the Ophthalmology Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; and Dr. Kaliki is now at the Ocular Oncology Service, L V Prasad Eye Institute, Hyderabad, India.
authors.forename: Saad A
authors.initials: SA
authors.lastname: Al-Dahmash
authors.forename: Carol L
authors.initials: CL
authors.lastname: Shields
authors.forename: Swathi
authors.initials: S
authors.lastname: Kaliki
authors.forename: Timothy
authors.initials: T
authors.lastname: Johnson
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Shields
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology; D002830:Choroid Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology; D012189:Retrospective Studies; D058471:Subretinal Fluid; D013964:Thyroid Neoplasms / Q000473:pathology; D041623:Tomography, Optical Coherence; D014792:Visual Acuity