Schaudig U, Hassenstein A, Bernd A, Walter A, Richard G
Augenklinik und Poliklinik, Universitäts-Krankenhaus Eppendorf, Hamburg, Germany.
Graefes Arch Clin Exp Ophthalmol. 1998 Aug;236(8):588-92. doi: 10.1007/s004170050126.
Optical coherence tomography (OCT) produces two-dimensional cross-sectional images with a longitudinal resolution of 10 microns. Its capacity for imaging retinal structure has been shown in a variety of diseases. There are no reports on its capacity and limitations in imaging choriocapillary and choroidal structures.
Twenty-two patients with the diagnosis of malignant melanoma of the choroid were submitted to OCT. We used a prototype and a commercial device, both with an 850-nm superluminescent diode with a band-width of 30 nm (reported longitudinal resolution 10 microns). The images were evaluated for retinal thickness, changes in retinal pigment epithelium, subretinal fluid accumulation and changes in choriocapillary or choroidal reflectivity.
Retinal edema and detachment found on biomicroscopic examination for fluorescein angiography was detected by OCT in all such cases. In 2 of 22 cases small retinal detachments were detected only by OCT. Tumor extension through the retinal pigment epithelium was not seen in this series, either by biomicroscopy or by OCT. The pattern of choroidal or choriocapillary reflectivity was nonspecifically lower than that of normal choroid, but did not yield any additional information about tumor histology. When normal retina was present, the OCT appearance of a malignant melanoma resembled that of normal choroid.
OCT may provide information about the retinal structure overlying prominent tumors and the extent of adjacent retinal detachment. In its present state of development, OCT is of little value in the differential diagnosis of choroidal tumors. Its potential value for the follow-up of shallow tumors needs further investigation.
光学相干断层扫描（OCT）可生成纵向分辨率为10微米的二维横截面图像。其对视网膜结构的成像能力已在多种疾病中得到证实。目前尚无关于其对脉络膜毛细血管和脉络膜结构成像能力及局限性的报道。
22例被诊断为脉络膜恶性黑色素瘤的患者接受了OCT检查。我们使用了一台原型设备和一台商用设备，二者均配备带宽为30纳米的850纳米超发光二极管（报道的纵向分辨率为10微米）。对图像进行评估，观察视网膜厚度、视网膜色素上皮的变化、视网膜下液积聚以及脉络膜毛细血管或脉络膜反射率的变化。
在所有荧光素血管造影生物显微镜检查发现视网膜水肿和脱离的病例中，OCT均检测到了这些情况。在22例病例中的2例中，仅通过OCT检测到了小的视网膜脱离。在本系列病例中，无论是生物显微镜检查还是OCT检查，均未发现肿瘤通过视网膜色素上皮的扩展情况。脉络膜或脉络膜毛细血管的反射率模式非特异性地低于正常脉络膜，但未提供有关肿瘤组织学的任何额外信息。当存在正常视网膜时，脉络膜恶性黑色素瘤的OCT表现类似于正常脉络膜。
OCT可提供有关突出肿瘤上方视网膜结构及相邻视网膜脱离范围的信息。在其目前的发展状态下，OCT在脉络膜肿瘤的鉴别诊断中价值不大。其对浅表肿瘤随访的潜在价值需要进一步研究。
