• Written By: Patel S. Purnima, MD
    Retina/Vitreous

    The authors used personal experience and published reports to review the topographical and intralesional patterns of various types of intraocular tumors as shown on enhanced depth imaging OCT.

    Choroidal nevi showed a smooth but moderate dome shape with overlying retinal pigment epithelium irregularities, subretinal clefts and photoreceptor loss. Choroidal melanoma also showed a smooth but moderate dome shape and smooth overlying “shaggy” photoreceptors. Choroidal metastasis showed an irregular surface topography with subretinal fluid and overlying shaggy photoreceptors. Choroidal hemangioma was smooth but with an acute dome shape with the presence of subretinal fluid and/or cystoid retinal edema.

    Choroidal lymphoma showed a rippled or corrugated surface. Choroidal osteoma displayed a smooth undulating surface with intralesional lamellar lines and tubules, representing bone lamellae or vessels. Choroidal melanocytosis had a flat but uniformly thickened choroid with increased stromal density. Choroidal hemorrhage displayed a slightly “scalloped” surface in the outer choroid.

    All choroidal tumors showed inward compression of the choroidal vasculature, except for hemangioma, in which the vessels were expanded. Retinal tumors, such as small retinoblastoma, astrocytic hamartoma and hemangioblastoma, rose abruptly amid the normal retina.

    They conclude that enhanced depth imaging OCT is an important tool for imaging intraocular tumors, allowing localization into retinal, choroidal or scleral layers; providing anatomic information that is useful for diagnosis and estimation of visual acuity; and allowing submillimeter monitoring. Further developments with OCT could assist with enhanced detection of intraocular tumors, particularly those that could be vision- or life-threatening, allowing for earlier detection and improved outcomes.