Author: Ahmet Kaan Gündüz

Affiliation: Professor of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey

Purpose: To evaluate the SS-OCT and SS-OCTA findings (using Topcon Triton Plus) in patients with intraocular tumors and assess the changes after treatment.

Methods: A total of 39 eyes including 27 treatment naive choroidal and retinal tumors and 12 choroidal tumors after treatment were included in this study.  Treatment naive fundus tumors included choroidal hemangioma (13 eyes), choroidal melanocytic lesions (10 eyes), primary vitreoretinal lymphoma (2 eyes), choroidal granuloma (1 eye), and retinal astrocytic hamartoma (1 eye). In addition, 12 eyes with choroidal melanoma treated with transpupillary thermotherapy (TTT) or radiation treatment (plaque radiotherapy or cyberknife radiosurgery) were evaluated using SS-OCT and SS-OCTA. Other multimodal imaging methods including color fundus photography, fundus autofluorescence, ultrasonography, and fluorescein angiography were performed in various combinations as necessary.

Results: On SS-OCT, choroidal hemangiomas showed a distinctly different pattern including choriocapillaris preservation and thickening in contrast to choroidal melanocytic lesions demonstrating loss of choriocapillaris. On SS-OCTA, suspicious choroidal melanocytic lesions and melanomas had outer retinal and choriocapillaris involvement versus only choriocapillaris involvement in choroidal hemangiomas. SS-OCTA elegantly showed the deep retinal vascular network in RAH and a hyporeflective network in choroidal granuloma. After TTT, there was marked atrophy of the inner retina on SS-OCT. SS-OCTA was instrumental in showing retinal nonperfusion, macular edema, vascular abnormalities, and neovascularization after both radiotherapy and TTT as a noninvasive method.

Conclusions: SS-OCT has been found to be extremely useful and noninferior to spectral domain OCT systems in analyzing the retinal and choroidal changes up to the sclera in cases with retinal and choroidal tumors. On SS-OCTA, there was a clear distinction between choroidal melanocytic tumors and hemangiomas. SS-OCTA was critical in showing postreatment changes after TTT and radiation. The addition of SS-OCT and SS-OCTA technology to our armamentarium has greatly improved the evaluation and differential diagnosis of retinal and choroidal tumors and monitor morphological changes after treatment.

Financial disclosure: The author received travel grant from Topcon (Optik Medical, İstanbul, Turkey).