SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN SMALL CHOROIDAL MELANOMAS AND CHOROIDAL NEVI. Issue 6 (June 2021)

• Record Type: Journal Article
• Authors: Greig, Eugenia Custo; Laver, Nora V.; Mendonca, Luisa S.M.; Levine, Emily S.; Baumal, Caroline R.; Waheed, Nadia K.; Duker, Jay S.
• Is Part Of: Retina. Volume 41:Issue 6(2021)
• Publication Date: 2021-06
• Subjects: choroidal melanoma -- choroidal nevi -- swept-source optical coherence tomography angiography; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000003053
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To evaluate the use of swept-source optical coherence tomography angiography to detect distinct vascular features in small choroidal melanomas and choroidal nevi. Methods: Patients with a choroidal nevus or a treatment-naïve choroidal melanoma were imaged with color fundus photography, ultrasound, and swept-source optical coherence tomography angiography (12 × 12 mm). High-risk features including overlying fluid, orange pigment, shaggy photoreceptors, acoustic hollowness, depth >2 mm, and basal diameter >5 mm were assessed. Optical coherence tomography angiography vascular markers included: choroidal vessel visualization, choroidal vessel depth, and choriocapillaris flow signal, assessed qualitatively by comparison with surrounding, unaffected choriocapillaris. Results: Twenty-nine lesions were included in this study, seven flat choroidal nevi, 17 elevated choroidal nevi, and 5 choroidal melanomas. Distinct vascular patterns were noted between flat nevi, elevated nevi, and small choroidal melanomas. Choroidal melanomas displayed two types of vasculature: "nevus-like" vasculature with straight parallel vessels and complex vasculature with vascular loops and crosslinking. Visualized choroidal vessels were significantly deeper in melanomas (110 µ m) than elevated (84 µ m) or flat nevi (70 µ m). In a size-matched subanalysis of 5 elevated choroidal nevi and 5 choroidal melanomas, choroidal melanomas had increased mean choroidal vessel depth ( P = 0.015), deepest choroidal vessel visualized ( P = 0.034), and presence of a deep choroidal vessel >155 µ m ( P = 0.048). Conclusion: Swept-source optical coherence tomography angiography may detect distinct vascular features in choroidal nevi and small choroidal melanomas. Abstract : The study explores the use of swept-source optical coherence tomography angiography to identify distinguishing vascular features in choroidal nevi and small choroidal melanomas. Choroidal melanomas displayed distinct vascular patterns. The presence of deep choroidal vasculature was more common in choroidal melanomas, even when compared with size-matched elevated choroidal nevi.