Shields Carol L, Materin Miguel A, Shields Jerry A
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Curr Opin Ophthalmol. 2005 Jun;16(3):141-54. doi: 10.1097/01.icu.0000158258.01681.40.
Optical coherence tomography has assumed an important role in the management of numerous ocular conditions. With regard to ocular oncology, optical coherence tomography can illustrate retinal changes overlying choroidal tumors. Some of these features include photoreceptor loss, intraretinal edema, and retinal thinning overlying choroidal nevus; fresh subretinal fluid with preservation of photoreceptors overlying choroidal melanoma; and intraretinal edema, retinoschisis, and retinal thinning overlying irradiated choroidal melanoma.
The optical coherence tomography features of tumors of the retinal pigment epithelium include typical findings of peaked vitreoretinal traction and retinal disorganization with combined hamartoma of the retina and retinal pigment epithelium, full-thickness retinal shadowing with congenital simple hamartoma, and photoreceptor loss and retinal thinning overlying congenital hypertrophy of the retinal pigment epithelium.
Optical coherence tomography of retinal tumors, such as retinoblastoma and astrocytic hamartoma, reveals full-thickness replacement of the retinal anatomic layers with the tumor and shadowing corresponding to the intralesional calcification. For all intraocular tumors, optical coherence tomography provides valuable information regarding the status of the retina and the retinal pigment epithelium and can be useful in ascertaining reasons for visual loss.
光学相干断层扫描在多种眼部疾病的管理中发挥着重要作用。在眼部肿瘤方面,光学相干断层扫描能够显示脉络膜肿瘤上方的视网膜变化。其中一些特征包括脉络膜痣上方的光感受器丧失、视网膜内水肿和视网膜变薄;脉络膜黑色素瘤上方有新鲜的视网膜下液且光感受器保留;以及照射后的脉络膜黑色素瘤上方的视网膜内水肿、视网膜劈裂和视网膜变薄。
视网膜色素上皮肿瘤的光学相干断层扫描特征包括视网膜玻璃体牵引峰值和视网膜结构紊乱合并视网膜和视网膜色素上皮错构瘤的典型表现、先天性单纯错构瘤导致的全层视网膜阴影,以及视网膜色素上皮先天性肥大上方的光感受器丧失和视网膜变薄。
视网膜肿瘤如视网膜母细胞瘤和星形细胞瘤错构瘤的光学相干断层扫描显示肿瘤完全替代视网膜解剖层以及与病灶内钙化相对应的阴影。对于所有眼内肿瘤,光学相干断层扫描可提供有关视网膜和视网膜色素上皮状态的有价值信息,并有助于确定视力丧失的原因。