Choroidal pigmented lesions imaged by ultra-wide-field scanning laser ophthalmoscopy with two laser wavelengths (Optomap)

Marcus Kernt, Ulrich C Schaller, Carmen Stumpf, Michael W Ulbig, Anselm Kampik, Aljoscha S NeubauerDepartment of Ophthalmology, Ludwig-Maximilians-University, Munich, GermanyPurpose: Clinical differentiation of choroidal pigmented lesions is sometimes difficult. &shy;Choroidal melanoma is th...

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Autores principales:	Marcus Kernt, Ulrich C Schaller, Carmen Stumpf, et al
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/9c3f138eee1745e78c38c3fc89cbdeca
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spelling	oai:doaj.org-article:9c3f138eee1745e78c38c3fc89cbdeca2021-12-02T00:03:00ZChoroidal pigmented lesions imaged by ultra-wide-field scanning laser ophthalmoscopy with two laser wavelengths (Optomap)1177-54671177-5483https://doaj.org/article/9c3f138eee1745e78c38c3fc89cbdeca2010-07-01T00:00:00Zhttp://www.dovepress.com/choroidal-pigmented-lesions-imaged-by-ultra-wide-field-scanning-laser--a4886https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Marcus Kernt, Ulrich C Schaller, Carmen Stumpf, Michael W Ulbig, Anselm Kampik, Aljoscha S NeubauerDepartment of Ophthalmology, Ludwig-Maximilians-University, Munich, GermanyPurpose: Clinical differentiation of choroidal pigmented lesions is sometimes difficult. &shy;Choroidal melanoma is the most prevalent primary neoplasia among malignant ocular tumors, and metastasis often occurs before the primary tumor is diagnosed. Therefore, early detection is essential. We investigated the imaging properties of clinically diagnosed melanocytic choroidal tumors using a nonmydriatic ultra-wide-field scanning laser ophthalmoscope (SLO) with two laser wavelengths to distinguish benign from malignant lesions. Repeated standardized ultrasound (US) evaluation provided reference standard.Methods: In a consecutive series of 49 patients with clinically diagnosed melanocytic &shy;choroidal tumors in one eye, 29 had established melanoma (defined by proven growth on repeated US follow-up) and 20 had nevi (defined by no malignancy according to clinical, US, and growth &shy;characteristics for at least 2 years). All patients underwent clinical examination, undilated Optomap? (Optos PLC, Dunfermline, Fife, Scotland, UK) imaging, standardized US &shy;examination, and standard retinal photography. Measurements of the tumor base using the Optomap software were compared with US B-scan measurements. Imaging characteristics from the SLO images were correlated with the structural findings in the two patient groups.Results: Measurements of tumor base correlated well between SLO and US with r = 0.61 (T-direction) and r = 0.51 (L-direction). On SLO imaging, typical malignant lesions appeared dark on the red laser channel and bright on the green laser channel. Based on those simple binary characteristics, a sensitivity of 76% at a specificity of 70% was obtained for a correct classification of lesions. When analogous to clinical examination lesion size, margin touching the optic disc, and existence of subretinal fluid were additionally considered, 90% sensitivity at 82% specificity was obtained.Conclusions: In this first, limited series, nonmydriatic SLO imaging with two laser wavelengths permitted to differentiate malignant ocular tumors from nonmalignant lesions with high &shy;diagnostic accuracy. Additional parameters may further enhance diagnostic properties, but larger patient series are required to validate our findings and prove the diagnostic properties.Keywords: choroidal melanoma, nevus, imaging, ultra-wide-field scanning laser ophthal&shy;moscopy Marcus KerntUlrich C SchallerCarmen Stumpfet alDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2010, Iss default, Pp 829-836 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Marcus Kernt Ulrich C Schaller Carmen Stumpf et al Choroidal pigmented lesions imaged by ultra-wide-field scanning laser ophthalmoscopy with two laser wavelengths (Optomap)
description	Marcus Kernt, Ulrich C Schaller, Carmen Stumpf, Michael W Ulbig, Anselm Kampik, Aljoscha S NeubauerDepartment of Ophthalmology, Ludwig-Maximilians-University, Munich, GermanyPurpose: Clinical differentiation of choroidal pigmented lesions is sometimes difficult. &shy;Choroidal melanoma is the most prevalent primary neoplasia among malignant ocular tumors, and metastasis often occurs before the primary tumor is diagnosed. Therefore, early detection is essential. We investigated the imaging properties of clinically diagnosed melanocytic choroidal tumors using a nonmydriatic ultra-wide-field scanning laser ophthalmoscope (SLO) with two laser wavelengths to distinguish benign from malignant lesions. Repeated standardized ultrasound (US) evaluation provided reference standard.Methods: In a consecutive series of 49 patients with clinically diagnosed melanocytic &shy;choroidal tumors in one eye, 29 had established melanoma (defined by proven growth on repeated US follow-up) and 20 had nevi (defined by no malignancy according to clinical, US, and growth &shy;characteristics for at least 2 years). All patients underwent clinical examination, undilated Optomap? (Optos PLC, Dunfermline, Fife, Scotland, UK) imaging, standardized US &shy;examination, and standard retinal photography. Measurements of the tumor base using the Optomap software were compared with US B-scan measurements. Imaging characteristics from the SLO images were correlated with the structural findings in the two patient groups.Results: Measurements of tumor base correlated well between SLO and US with r = 0.61 (T-direction) and r = 0.51 (L-direction). On SLO imaging, typical malignant lesions appeared dark on the red laser channel and bright on the green laser channel. Based on those simple binary characteristics, a sensitivity of 76% at a specificity of 70% was obtained for a correct classification of lesions. When analogous to clinical examination lesion size, margin touching the optic disc, and existence of subretinal fluid were additionally considered, 90% sensitivity at 82% specificity was obtained.Conclusions: In this first, limited series, nonmydriatic SLO imaging with two laser wavelengths permitted to differentiate malignant ocular tumors from nonmalignant lesions with high &shy;diagnostic accuracy. Additional parameters may further enhance diagnostic properties, but larger patient series are required to validate our findings and prove the diagnostic properties.Keywords: choroidal melanoma, nevus, imaging, ultra-wide-field scanning laser ophthal&shy;moscopy
format	article
author	Marcus Kernt Ulrich C Schaller Carmen Stumpf et al
author_facet	Marcus Kernt Ulrich C Schaller Carmen Stumpf et al
author_sort	Marcus Kernt
title	Choroidal pigmented lesions imaged by ultra-wide-field scanning laser ophthalmoscopy with two laser wavelengths (Optomap)
title_short	Choroidal pigmented lesions imaged by ultra-wide-field scanning laser ophthalmoscopy with two laser wavelengths (Optomap)
title_full	Choroidal pigmented lesions imaged by ultra-wide-field scanning laser ophthalmoscopy with two laser wavelengths (Optomap)
title_fullStr	Choroidal pigmented lesions imaged by ultra-wide-field scanning laser ophthalmoscopy with two laser wavelengths (Optomap)
title_full_unstemmed	Choroidal pigmented lesions imaged by ultra-wide-field scanning laser ophthalmoscopy with two laser wavelengths (Optomap)
title_sort	choroidal pigmented lesions imaged by ultra-wide-field scanning laser ophthalmoscopy with two laser wavelengths (optomap)
publisher	Dove Medical Press
publishDate	2010
url	https://doaj.org/article/9c3f138eee1745e78c38c3fc89cbdeca
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Choroidal pigmented lesions imaged by ultra-wide-field scanning laser ophthalmoscopy with two laser wavelengths (Optomap)

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