Multimodal imaging in choroidal metastasis

Background: Choroidal metastasis represent the most common malignant intraocular tumours. Objectives: To detect the structural and vascular features of choroidal metastasis by multimodal imaging. Methods: Sixteen eyes of 16 patients with choroidal metastasis were enrolled in this prospective study. The multimodal imaging was performed in all patients: fluorescein angiography, indocyanine green angiography, enhanced depth imaging optical coherence tomography (EDI-OCT), OCT angiography (OCTA) and ultrasonography. Results: The choroidal metastasis were located in the macula region in 9 eyes (57%) and in the extramacular region in 7 eyes (43%). EDI-OCT showed a mean thickness of 950 ± 246 µm, a smooth anterior tumour surface in 5 eyes (31%) and a lumpy bumpy appearance in 11 eyes (69%). The most frequent EDI-OCT features were represented by choriocapillaris thinning (100%), shaggy photoreceptors (82%), subretinal fluid with speckles (69%), subretinal lipofuscin pigment (6%), absence of drusen (100%), optical shadowing (94%), low internal optical reflectivity (75%) and retinal pigment epithelium alterations (43%). OCTA revealed an absence of intratumoral vascular network in all cases.

Intraocular tumours

‘Intraocular tumours’ provides the reader with a practical approach to the assessment and management of these diseases. This chapter includes iris tumours, ciliary body tumours, choroidal tumours (including melanoma and haemangioma), retinoblastoma, retinal pigment epithelium tumours and lymphoma. Using a patient-centred approach the key clinical features, investigations and treatment (medical and surgical) are described for each condition.

Tumours of the eye and orbit

This chapter provides information about the tumours of the eye and orbit, including benign and malignant lesions of the conjunctiva and ocular adnexa as well as intraocular tumours, such as uveal melanoma, vascular tumours, and lymphoma of the retina and CNS. The chapter also provides information on the symptoms and signs of such lesions, the recommended examination and imaging procedures, the principles of management and treatment, assessment of quality of life, as well as on prognosis, histopathology, differential diagnoses, and molecular biology. Each section discusses not only optimal potentially curative management, but also long-term follow-up and maintenance of vision.

Intraocular tumours

‘Intraocular tumours’ provides the reader with a practical approach to the assessment and management of these diseases. This chapter includes iris tumours, ciliary body tumours, choroidal tumours (including melanoma and haemangioma), retinoblastoma, retinal pigment epithelium tumours and lymphoma. Using a patient-centred approach the key clinical features, investigations and treatment (medical and surgical) are described for each condition.