Multimodal imaging of amelanotic choroidal melanoma

2020 ◽  
pp. 112067212093618
Author(s):  
Luisa Pierro ◽  
Alessandro Arrigo ◽  
Emanuela Aragona ◽  
Francesco Bandello
Keyword(s):  
Optical Coherence Tomography ◽  
Blood Vessels ◽  
Malignant Tumor ◽  
Multimodal Imaging ◽  
Optical Coherence Tomography Angiography ◽  
Complex Structure ◽  
Choroidal Melanoma ◽  
Relevant Information ◽  
Vascular Network ◽  
Imaging Features

Amelanotic choroidal melanoma (ACM) is an extremely rare malignant tumor affecting the uvea. Because of the complex structure characterizing this kind of lesions, its morphologic features are partially understood, especially if looking to its vascular network. In this paper, we described in details the multimodal imaging features of ACM. Moreover, we disclosed new insights about different orders of blood vessels characterizing this tumor. Despite the entire vascular network is partially detectable by conventional dye-based angiography, it was reconstructed in its entirety by means of optical coherence tomography angiography. In conclusion, multimodal imaging represents a feasible and useful set of tools, able to describe in deep ACM features and its vascular network organization, and to provide clinically relevant information for ACM management.

Is optical coherence tomography angiography helpful in the differential diagnosis of choroidal nevus versus melanoma?

2019 ◽  
Vol 30 (4) ◽  
pp. 723-729 ◽  
Author(s):  
Claudia Garcia-Arumi Fuste ◽  
Federico Peralta Iturburu ◽  
Jose Garcia-Arumi
Keyword(s):  
Optical Coherence Tomography ◽  
Differential Diagnosis ◽  
Optical Coherence Tomography Angiography ◽  
Choroidal Melanoma ◽  
Fundus Photography ◽  
Imaging Features ◽  
Optical Coherence ◽  
Vascular Networks ◽  
Choroidal Nevus ◽  
Choroidal Nevi

Purpose: To describe the imaging features of choroidal nevus and melanoma using optical coherence tomography angiography, and evaluate the ability of this technique to establish the differential diagnosis based on the display of the tumor’s intrinsic vasculature. Methods: Comparative analysis of optical coherence tomography angiography findings in consecutive patients diagnosed with choroidal nevus or choroidal melanoma following a complete ophthalmic evaluation, including best-corrected visual acuity and several imaging studies: color fundus photography, B-scan ultrasound, spectral-domain optical coherence tomography, and optical coherence tomography angiography. Optical coherence tomography angiography was used to investigate qualitative differences in the tumor vasculature. Results: Thirty-six eyes (18 cases of choroidal nevus and 18 cases of choroidal melanoma) from 36 consecutive patients were included in the study. Only cases located posterior to equator were included to enable performance of all tests. On optical coherence tomography angiography, choroidal nevus showed well-delimited margins (78%), hyperreflective choroid capillary vasculature (83%), fewer avascular areas (17%), and neovascular membrane in one case (6%). Choroidal melanoma showed imprecise margins (72%), hyporeflective choroidal capillary vasculature (72%), multiple avascular areas (78%), and choroidal vascular changes (e.g. thick vascular networks or vascular loops; 45%). Conclusion: Optical coherence tomography angiography can provide useful information for assessing and differentiating between choroidal nevi and small melanomas. Significant differences between these conditions were found for the pattern of reflectivity, and presence/absence of avascular zones and vascular anomalies, which could be helpful for supporting the diagnosis.

scholarly journals Optical Coherence Tomography Angiography Features of Macular Epiretinal Neovascularization In Eales’ Disease: A Case Rreport

2021 ◽  
Author(s):  
Nora Alyousif ◽  
Abrar K. Alsalamah ◽  
Hassan Aldhibi
Keyword(s):  
Optical Coherence Tomography ◽  
Blood Vessels ◽  
Optic Disc ◽  
Optical Coherence Tomography Angiography ◽  
Internal Limiting Membrane ◽  
Peripheral Retina ◽  
Optical Coherence ◽  
Retinal Capillary ◽  
Eales Disease ◽  
The Right

Abstract Background: Eales disease primarily affects the peripheral retina. However, posterior involvement can be seen. Macular epiretinal neovascularization is not commonly seen in Eales disease. This report highlights the morphology and origin of macular epiretinal neovascularization (ERN) using multimodal retinal imaging, including optical coherence tomography angiography (OCTA). Results: A 35-year-old man with no history of systemic disorders presented with gradual decrease of vision in his left eye. Fundus examination of his right eye showed peripheral sclerosed blood vessels, neovascularization of the optic disc and elsewhere, and macular ERN. The view of the left fundus was limited by vitreous haemorrhage. Fluorescein angiography (FA), of the right eye showed widespread peripheral capillary nonperfusion and leakage of dye from the retinal neovascularization and macular ERN. Macular Spectral domain optical coherence tomography (SD-OCT) of the right eye showed an epiretinal membrane and the presence of epiretinal neovascular lesions extending above the internal limiting membrane towards the vitreous. Optical coherence tomography angiography (OCTA) showed multiple tiny blood vessels at the macula that arose from the superficial retinal capillary plexuses and extended toward the vitreous. The corresponding B-scan showed flow signal through these vessels and the signal extend above the internal limiting membrane. Systemic work-up was negative except for strongly positive tuberculin skin testing giving the classic diagnosis of Eales disease. Patient was started on empirical anti-tubercular therapy and oral corticosteroids. Scatter laser photocoagulation was applied to nonperfused retinal zones. Despite adequate scatter laser ablation, the ERN failed to regress fully. Conclusions: Macular ERN can be seen in cases of classic Eales disease. The origin of macular ERN in our case was shown to be from the superficial retinal capillary plexuses. We also noted the slower regression rate of macular ERN as compared to the major neovascularizations of the optic disc and peripheral retina. Further research is needed to establish the pathogenesis of ERN and its optimal management.

Dark and white lesions observed in central serous chorioretinopathy on optical coherence tomography angiography

2018 ◽  
Vol 28 (4) ◽  
pp. 446-453 ◽  
Author(s):  
Flore De Bats ◽  
Pierre-Loïc Cornut ◽  
Benjamin Wolff ◽  
Laurent Kodjikian ◽  
Martine Mauget-Faÿsse
Keyword(s):  
Optical Coherence Tomography ◽  
Central Serous Chorioretinopathy ◽  
Multimodal Imaging ◽  
Optical Coherence Tomography Angiography ◽  
Pigment Epithelium ◽  
Serous Retinal Detachment ◽  
Descriptive Study ◽  
Dark Spot ◽  
Optical Coherence ◽  
Choroidal Neovascular Membrane

Purpose: To describe abnormal dark (hyposignal) and white (hypersignal) lesions observed on optical coherence tomography angiography in central serous chorioretinopathy. Methods: Prospective, multicenter, and descriptive study including patients with active or quiescent central serous chorioretinopathy. All patients had undergone a complete ophthalmic examination. Results: Abnormal dark lesions were detected as “dark spots” and “dark areas” on optical coherence tomography angiography. A “dark spot” could correspond to six different abnormalities: pigment epithelium detachment, subretinal deposit, “Lucency” within surrounding subretinal fibrin, choroidal cavitation, choroidal excavation, and choroidal fluid. A “dark area” could be related to a serous retinal detachment or choriocapillary compression. Abnormal white lesions were also detected: A “white spot” could correspond with the leaking point on fluorescein angiography or with hyper-reflective dots; A “white filamentous pattern” at the Brüch’s membrane level corresponded to abnormal choroidal neovascular vessels. Conclusion: A semiology is described using optical coherence tomography angiography in central serous chorioretinopathy as abnormal dark and white lesions. Multimodal imaging is mandatory in addition to optical coherence tomography angiography to diagnose non-neovascular retinal and choroidal central serous chorioretinopathy lesions. However, optical coherence tomography angiography alone is helpful in detecting choroidal neovascular membrane in central serous chorioretinopathy.

Multimodal imaging evaluation of combined hamartoma of the retina and retinal pigment epithelium

2019 ◽  
Vol 30 (3) ◽  
pp. 595-599 ◽  
Author(s):  
Andrea Scupola ◽  
Gabriela Grimaldi ◽  
Maria G Sammarco ◽  
Paola Sasso ◽  
Michele Marullo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Pigment Epithelium ◽  
Multimodal Imaging ◽  
Optical Coherence Tomography Angiography ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Case Series ◽  
Variable Degree ◽  
Optical Coherence ◽  
Imaging Evaluation

Purpose: Combined hamartoma of the retina and retinal pigment epithelium is a rare benign tumor characterized by a variable combination of glial, vascular, and pigmented components. The purpose of our study was to analyze the features of combined hamartoma of the retina and retinal pigment epithelium on optical coherence tomography angiography. Methods: Small case series of two cases of combined hamartoma of the retina and retinal pigment epithelium with macular and optic nerve involvement, evaluated with multimodal imaging including optical coherence tomography, fluorescein angiography, and optical coherence tomography angiography. Results: On optical coherence tomography, combined hamartoma of the retina and retinal pigment epithelium is characterized by disruption of the inner neurosensory retina and a variable degree of involvement of the external retina. Optical coherence tomography angiography showed diffuse alterations of the retinal vessels of the superficial and deeper layers, extended to the peripapillary area. Vessel abnormalities included increased tortuosity and caliber of vessels, vascular traction, and vessel stretching within the lesion. Conclusion: Optical coherence tomography angiography allows in-depth multilayer analysis of tumor vascular network, highlighting the fine abnormalities of retinal vasculature characteristic of combined hamartoma of the retina and retinal pigment epithelium.

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