L V Prasad Eye Institute, KVC Campus, Vijayawada, Andhra Pradesh, Andhra Pradesh, India; Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
L V Prasad Eye Institute, KAR Campus, Hyderabad, Telangana, India.
Indian J Ophthalmol. 2021 Feb;69(2):332-336. doi: 10.4103/ijo.IJO_710_20.
The objective of this study was to identify the diagnostic features of optic nerve head melanocytoma (ONH-MCT) on spectral domain optical coherence tomography (SD OCT) and OCT angiography (OCT-A).
Retrospective study of 11 patients for their demographic, clinical features and imaging including SD OCT (tumour location, extent and interface) and OCT-A (surface and intrinsic vascularity) were reviewed. Flow rate percentage (FR %) was calculated over the lesion and compared to fellow eye and similar pigmented lesions.
The average age was 52.8 ± 10.9 years. ONH-MCT tumors occupied 3-tissue spaces- optic disc (n = 2), retinal layer (n = 5) and retina-choroidal layers (n = 4). SD OCT (11 eyes) showed elevated hyper reflective disorganized retinal layers with posterior shadowing (9 eyes) and hyper reflective dots within the tumor (all eyes). Microvascular features on OCT-A (8 eyes) in radial peripapillary capillary slab showed surface vascularization (7 eyes) and intrinsic vascularity in choroidal slab (8 eyes) with surrounding hypo reflective boundary. The mean FR % was higher at 65.1 ± 3.77% (CI: 61.9-68.2) compared to mean FR at 60.4 ± 1.06% (CI: 59.5-61.2) in the fellow eye (p = 0.01). Comparison with nevus and melanoma SD OCT showed a high reflective choroidal layer with normal or irregular outer retinal layers respectively; OCT-A showed hypo reflective area at the center with hyper reflective boundary and iso reflective area at center with hyper reflective boundary respectively.
SD OCT and OCT-A features may help to differentiate ONH-MCT from clinically similar looking pigmented lesions like nevus and melanoma.
本研究旨在通过频域光相干断层扫描（SD OCT）和 OCT 血管造影（OCT-A）来确定视神经乳头黑素细胞瘤（ONH-MCT）的诊断特征。
回顾性研究了 11 例患者的人口统计学、临床特征和影像学资料，包括 SD OCT（肿瘤位置、范围和界面）和 OCT-A（表面和固有血管）。计算了病变区域的血流率百分比（FR%），并与对侧眼和类似色素病变进行了比较。
平均年龄为 52.8 ± 10.9 岁。ONH-MCT 肿瘤占据 3 个组织空间——视盘（n = 2）、视网膜层（n = 5）和视网膜脉络膜层（n = 4）。SD OCT（11 只眼）显示出升高的、紊乱的、具有后影的高反射视网膜层（9 只眼）和肿瘤内的高反射点（所有眼）。OCT-A（8 只眼）的微血管特征在放射状视盘周围毛细血管层显示出表面血管化（7 只眼）和脉络膜层的固有血管化（8 只眼），周围有低反射边界。平均 FR%为 65.1 ± 3.77%（CI：61.9-68.2），高于对侧眼的 60.4 ± 1.06%（CI：59.5-61.2）（p = 0.01）。与痣和黑色素瘤的 SD OCT 相比，高反射性脉络膜层分别伴有正常或不规则的外层视网膜；OCT-A 显示出中心的低反射区，边界高反射，中心的等反射区，边界高反射。
SD OCT 和 OCT-A 的特征有助于将 ONH-MCT 与临床上类似的色素病变（如痣和黑色素瘤）区分开来。
