title: Anterior Segment Scleral Fluorescein Angiography in the Evaluation of Ciliary Body Neoplasm: Two Case Reports.
abstract: BACKGROUND
  Anterior segment tumors can be difficult to detect until tumor growth is substantial enough to cause local signs or symptoms. Earlier detection may result in improved outcomes, particularly the ability to option for globe-conserving therapy. Multiple diagnostic modalities such as ultrasound or optical coherence tomography exist to aid for earlier detection of ciliary body tumors, but they also have limitations. Here we describe the potential for scleral angiography as an adjunctive modality to assist in evaluating anterior segment ciliary body tumors.
  
  
  METHODS
  A 61-year-old Caucasian male and a 57-year-old Hispanic female presented for ciliary body tumor evaluation. The Caucasian male notably had abnormal scleral, episcleral, and conjunctival vessels in the affected eye. Scleral angiography was performed in both cases with the abnormal vasculature highlighted in the Caucasian male. The Hispanic female did not demonstrate abnormal scleral angiographic patterns. Notably, the Caucasian male also had regions of abnormal scleral angiography arising in locations of otherwise normal appearing sclera. Both patients had the affected eyes enucleated. Histology of the enucleated eyes demonstrated a ciliary body melanoma in the Caucasian male associated with abnormal vascular and tumor infiltration of the scleral bed. The Hispanic female had a pigmented ciliary body adenoma without involvement of the scleral bed.
  
  
  CONCLUSIONS
  With limited sample size, scleral angiography has the potential to detect abnormal scleral vascular patterns in otherwise normal appearing sclera in cases of ciliary body tumor with scleral vascular invasion.
authors.affiliation: Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, Calif., USA.
authors.forename: Amir H
authors.initials: AH
authors.lastname: Marvasti
authors.affiliation: USC Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, Calif., USA.
authors.forename: Jesse
authors.initials: J
authors.lastname: Berry
authors.affiliation: USC Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, Calif., USA.
authors.forename: Maria E Saber
authors.initials: ME
authors.lastname: Sibug
authors.affiliation: USC Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, Calif., USA.
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Doheny Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Calif., USA.
authors.forename: Alex S
authors.initials: AS
authors.lastname: Huang
keywords: Ciliary body; Ocular tumor; Scleral angiography