Department of Biomedical and Clinical Science "Luigi Sacco," Eye Clinic, Luigi Sacco Hospital, University of Milan, Milan, Italy.
Save Sight Institute, Sydney Eye Hospital, University of Sydney, Sydney, Australia.
Retina. 2019 Aug;39(8):1510-1519. doi: 10.1097/IAE.0000000000002205.
To describe the imaging features of choroidal melanoma using swept-source optical coherence tomography angiography (SS-OCT-A) and to evaluate its ability to display tumor intrinsic vasculature.
Consecutive patients diagnosed with choroidal melanoma underwent a complete ophthalmic evaluation, including best-corrected visual acuity, color fundus photography, B-scan ultrasound, fluorescein angiography, indocyanine green angiography, and SS-OCT-A (PLEX Elite 9000; Carl Zeiss Meditec, Inc, Dublin, CA).
Twenty-two eyes of 22 consecutive patients were included in the study; 11 cases (50%) were treatment naive. Three lesions (14%) were located at the macula, 14 (63%) between the macula and equator, and 5 (23%) between the equator and the ora serrata. The mean tumor base and thickness were, respectively, 10.3 mm (range 5-15 mm) and 4.3 mm (range 1.5-8.9 mm). Seventeen lesions (77%) were dome shaped, whereas 5 (23%) had a mushroom configuration. Thirteen lesions (59%) were pigmented, 5 (23%) partially pigmented, and 4 (18%) amelanotic. An exudative retinal detachment was documented in 13 eyes (59%). Fluorescein angiography and indocyanine green angiography were performed in 20 patients and disclosed intrinsic microvasculature of the tumor, respectively, in 4 (20%) and 20 (100%) cases. Swept-source optical coherence tomography angiography was performed in 22 eyes and detected microvasculature of choroidal melanoma in all cases. Specifically, intrinsic vasculature could be recognized in 14 eyes (64%) using the automated choroid segmentation, 16 eyes (73%) using the automated whole eye segmentation, and in 22 eyes (100%) with fine manual adjustments of segmentation lines.
Swept-source optical coherence tomography angiography represents a valid imaging technique to evaluate patients affected by choroidal melanomas. In our series, SS-OCT-A disclosed the intrinsic microvasculature of the tumor in all cases despite their size, location, and history of previous treatments.
利用扫频源光相干断层扫描血管造影术（SS-OCT-A）描述脉络膜黑色素瘤的影像学特征，并评估其显示肿瘤固有血管的能力。
连续确诊为脉络膜黑色素瘤的患者接受了全面的眼科评估，包括最佳矫正视力、眼底彩色照相、B 型超声扫描、荧光素血管造影、吲哚青绿血管造影和 SS-OCT-A（PLEX Elite 9000；卡尔蔡司 Meditec，Inc，都柏林，CA）。
本研究纳入了 22 例 22 只眼连续患者；11 例（50%）为初治患者。3 个病灶（14%）位于黄斑区，14 个（63%）位于黄斑与赤道之间，5 个（23%）位于赤道与锯齿缘之间。肿瘤基底和厚度的平均值分别为 10.3mm（范围 5-15mm）和 4.3mm（范围 1.5-8.9mm）。17 个病灶（77%）呈半球形，5 个（23%）呈蘑菇形。13 个病灶（59%）为色素性，5 个（23%）为部分色素性，4 个（18%）为非色素性。13 只眼（59%）出现渗出性视网膜脱离。20 例患者行荧光素血管造影和吲哚青绿血管造影，分别有 4 例（20%）和 20 例（100%）显示肿瘤固有微脉管系统。22 只眼行 SS-OCT-A 检查，均能检测到脉络膜黑色素瘤的微血管。具体而言，14 只眼（64%）采用自动脉络膜分割、16 只眼（73%）采用自动全眼分割、22 只眼（100%）采用精细手动调整分割线，均可识别肿瘤固有血管。
SS-OCT-A 是评估脉络膜黑色素瘤患者的一种有效的影像学技术。在我们的系列研究中，尽管肿瘤的大小、位置和既往治疗史不同，SS-OCT-A 仍能显示所有病例的肿瘤固有微血管。
