title: Swept-source optical coherence tomography features of choroidal nevi.
abstract: OBJECTIVE
  To investigate the morphologic characteristics of choroidal nevi using swept-source optical coherence tomography and compare this with enhanced-depth optical coherence tomography.
  
  
  METHODS
  Retrospective observational case series.
  
  
  METHODS
  One choroidal nevus each from 30 eyes of 30 patients was included and received imaging with swept-source OCT (SS-OCT) and enhanced-depth imaging OCT (EDI-OCT). For SS-OCT, a scan acquisition protocol was used involving 12 mm horizontal and vertical scans in the posterior fundus. The main outcome measures were morphologic features of choroidal nevi obtained with SS-OCT imaging. These features were compared to images obtained with EDI-OCT. A 2-tailed Fisher exact test was the statistical method used.
  
  
  RESULTS
  SS-OCT allowed for an appreciation of intralesional details: Of the 30 nevi imaged, intralesional vessels were apparent in 30 (100%), intralesional cavities in 6 (20%), intralesional granularity in 14 (47%), abnormal choriocapillaris in 25 (83%), and abnormal choriocapillaris confined to the tumor apex in 17 (58%). Distended bordering vessels were identified in 22 nevi (73%) and were significantly associated with the presence of previous or persistent subretinal fluid. Intrinsic hyperreflectivity with hyporeflective shadowing was significantly (P = .05) more apparent in 14 of 21 melanotic nevi (67%) compared with 2 of 9 amelanotic nevi (22%). Visualization of the complete nevus-scleral interface was significantly (P = .02) more apparent in 7 of 9 amelanotic nevi (78%) compared with 6 of 21 melanotic nevi (29%), and was not significantly related to tumor thickness (measured by ultrasound) or to tumor configuration. Tumor diameter (but not tumor height) was statistically significantly associated with secondary retinal changes (P = .05) and configuration (P = .01). EDI-OCT was equivalent at determining secondary retinal changes (P = .29), the presence of distended bordering vessels (P = 1), visualization of the nevus-scleral interface (P = .6), and hyporeflective gradation at the nevus-scleral interface (P = .33). However, in melanotic lesions, SS-OCT was significantly superior at visualizing intralesional vessels (P = .0002), intralesional granularity (P = .0005), and abnormal choriocapillaris (P = .0001).
  
  
  CONCLUSIONS
  Imaging of choroidal nevi with SS-OCT enables visualization of intralesional details such as vessels (present in 100% of tumors imaged), cavities, and granularity. For melanotic lesions, SS-OCT is significantly better at depicting certain intralesional characteristics compared to EDI-OCT. Distended bordering vessels were recognized in over two thirds of the nevi imaged and were significantly associated with previous or persistent subretinal fluid.
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York. Electronic address: francij1@mskcc.org.
authors.forename: Jasmine H
authors.initials: JH
authors.lastname: Francis
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York.
authors.forename: Claudine E
authors.initials: CE
authors.lastname: Pang
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York.
authors.forename: David H
authors.initials: DH
authors.lastname: Abramson
authors.affiliation: New York Eye and Ear Infirmary, New York, New York.
authors.forename: Tatyana
authors.initials: T
authors.lastname: Milman
authors.affiliation: Oakland University William Beaumont School of Medicine, Rochester, Minnesota.
authors.forename: Robert
authors.initials: R
authors.lastname: Folberg
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York.
authors.forename: Sarah
authors.initials: S
authors.lastname: Mrejen
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York.
authors.forename: K Bailey
authors.initials: KB
authors.lastname: Freund
mesh_terms: D002830:Choroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D009508:Nevus, Pigmented / Q000000981:diagnostic imaging / Q000473:pathology*; D012171:Retinal Vessels / Q000473:pathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D014463:Ultrasonography