Optical coherence tomography enhanced depth imaging of choroidal tumors

Am J Ophthalmol. 2011 Apr;151(4):586-593.e2. doi: 10.1016/j.ajo.2010.09.028. Epub 2011 Jan 22.


Purpose: To describe the spectral-domain optical coherence tomography (SD-OCT) features of choroidal tumors imaged using enhanced depth imaging (EDI) technique.

Design: Prospective observational case series.

Methods: One tumor each from 23 eyes of 23 patients was included. All the patients underwent clinical fundus photography, ultrasonography, and EDI SD-OCT. Qualitative characteristics (tumor outline, reflectivity and/or shadowing of choroidal layers, and detection of inner sclera) and quantitative characteristics (measurement of maximum tumor thickness and the largest tumor diameter) were assessed.

Results: Patients (male=12) were categorized as: amelanotic choroidal nevus (4), melanotic choroidal nevus (9), choroidal melanoma (3), circumscribed choroidal hemangioma (3), and choroidal metastasis (4). In all cases, EDI SD-OCT was able to identify the tumor distinctly from the surrounding normal choroid. Qualitative analysis revealed: amelanotic nevi, homogenous and medium reflective band with visible choroidal vessels; melanotic nevi and choroidal melanomas, high reflective band in the anterior choroid with shadowing, and nonvisualization of choroidal vessels and inner sclera; choroidal hemangiomas, medium/low reflective band without shadowing; and choroidal metastasis, low reflective band in the deep choroid with enlargement of the suprachoroidal space. Maximum tumor diameter and thickness was measurable by EDI SD-OCT only in 10 cases that were <9.0 mm in diameter and <1.0 mm in thickness (undetectable by ultrasonography).

Conclusions: It is possible to obtain cross-sectional views of a variety of choroidal tumors using EDI SD-OCT. Small choroidal tumors nondetectable by ultrasonography can be objectively measured by this technique.

MeSH terms

  • Choroid Neoplasms / diagnosis*
  • Choroid Neoplasms / pathology
  • Female
  • Hemangioma / diagnosis*
  • Hemangioma / pathology
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Melanoma / diagnosis*
  • Melanoma / pathology
  • Melanoma, Amelanotic / diagnosis*
  • Melanoma, Amelanotic / pathology
  • Nevus / diagnosis*
  • Nevus / pathology
  • Nevus, Pigmented / diagnosis*
  • Nevus, Pigmented / pathology
  • Photography
  • Prospective Studies
  • Tomography, Optical Coherence*
  • Ultrasonography