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

Author(s):  
Prithvi Mruthyunjaya
2019 ◽  
Vol 30 (4) ◽  
pp. 723-729 ◽  
Author(s):  
Claudia Garcia-Arumi Fuste ◽  
Federico Peralta Iturburu ◽  
Jose Garcia-Arumi

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.


2018 ◽  
Vol 9 (3) ◽  
pp. 504-509
Author(s):  
Helena Dens ◽  
Ingele Casteels

We describe a 7-year-old girl who developed exudation nasally to the right optic disc due to retinal arteriovenous malformation. Fluorescein angiography, spectral domain optical coherence tomography, and optical coherence tomography angiography were performed. We give an overview of the different imaging techniques and discuss the differential diagnosis. Since there was no visual impairment, no treatment was started. A spontaneous decrease in edema and exudation was noted after 6 months.


2016 ◽  
Vol 27 (1) ◽  
pp. 9-12 ◽  
Author(s):  
Maria Vittoria Cicinelli ◽  
Lorenzo Iuliano ◽  
Alessandro Rabiolo ◽  
Alessandro Marchese ◽  
Giuseppe Querques ◽  
...  

Purpose To report a case of juxtapapillary polypoidal choroidal neovascularization (PCNV) associated with choroidal nevus investigated by means of optical coherence tomography angiography (OCT-A). Methods Case report. Results A 72-year-old woman presented with visual loss and metamorphopsia in her left eye for 5 days secondary to PCNV that developed on the border of a juxtapapillary choroidal nevus. Fluorescein angiography, indocyanine green angiography, and spectral-domain OCT confirmed the diagnosis. En face OCT-A disclosed a large tangled hyperreflective PCNV spreading from the optic disc at different levels of the choriocapillaris; the polyp lumina appeared hyporeflective. The patient was treated with 3 intravitreal injections of anti-vascular endothelial growth factor with partial functional recovery. Conclusions Our case showed the application of OCT-A in the diagnosis of a case of active PCNV complicating a benign intraocular tumor.


Retina ◽  
2018 ◽  
Vol 38 (7) ◽  
pp. 1338-1346 ◽  
Author(s):  
Marco Pellegrini ◽  
Federico Corvi ◽  
Emil A. T. Say ◽  
Carol L. Shields ◽  
Giovanni Staurenghi

Retina ◽  
2017 ◽  
Vol 37 (4) ◽  
pp. 731-740 ◽  
Author(s):  
Alicia Valverde-Megías ◽  
Emil A. T. Say ◽  
Sandor R. Ferenczy ◽  
Carol L. Shields

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Victor M. Villegas ◽  
Armando L. Monroig ◽  
Lazaro H. Aguero ◽  
Stephen G. Schwartz

Optical coherence tomography angiography (OCT-A) is a recently established noninvasive technology for evaluation of the retinal and choroidal vasculature. The literature regarding the findings in choroidal nevi is scarce. We report the OCT-A findings associated with two different variants. Subject one had decreased vascular flow signal in the choroidal, choriocapillaris, deep retinal, and superficial retinal layers. Subject two had decreased vascular flow signal in the choroidal, choriocapillaris, and deep retinal layers with a normal vascular flow signal in the superficial retinal layer. To our knowledge, these patterns of decreased vascular flow signals have not been previously reported using OCT-A. This may be due to blockage from the choroidal nevus, true diminished blood flow (ischemia), or other factors.


2020 ◽  
pp. 112067212093439 ◽  
Author(s):  
Gilda Cennamo ◽  
Daniela Montorio ◽  
Federica Fossataro ◽  
Lidia Clemente ◽  
Raffaella Carandente ◽  
...  

Purpose: To report a case of quiescent choroidal neovascularization (CNV) associated with choroidal nevus using optical coherence tomography angiography (OCTA) during 5 years follow-up. Methods: Observational case report. Results: A 53-year old woman was referred our department with diagnosis of choroidal nevus. At 1 year follow-up, fundus autofluorescence revealed hyper/hypoautofluorescent area, infrared image showed hyperreflective area and enhanced depth imaging OCT presented a shallow pigment epithelium detachment without exudation or hemorrhage. Fluorescein angiography and indocyanine green angiography suspected the presence of CNV. Finally, OCTA confirmed a quiescent CNV with an increased flow area of the vascular lesion without any changes in best-corrected visual acuity. At 20 months and 5 years follow-up, the CNV remained quiescent showing no clinical activity on structural SD-OCT and no changes in CNV morphology on OCTA. Conclusion: This case shows the features of quiescent CNV secondary to choroidal nevus after long-term follow-up. OCTA represents a valid imaging technique that allows to identify the CNV and to monitor its progression over time.


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