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An Analysis of 22 Consecutive Cases

Pellegrini, Marco, MD*; Corvi, Federico, MD*; Invernizzi, Alessandro, MD*,†; Ravera, Vittoria, MD*; Cereda, Matteo G., MD*; Staurenghi, Giovanni, MD, FARVO*

doi: 10.1097/IAE.0000000000002205
Original Study: PDF Only

Purpose: To describe the imaging features of choroidal melanoma using swept-source optical coherence tomography angiography (SS-OCT-A) and to evaluate its ability to display tumor intrinsic vasculature.

Methods: Consecutive patients diagnosed with choroidal melanoma underwent a complete ophthalmic evaluation, including best-corrected visual acuity, color fundus photography, B-scan ultrasound, fluorescein angiography, indocyanine green angiography, and SS-OCT-A (PLEX Elite 9000; Carl Zeiss Meditec, Inc, Dublin, CA).

Results: Twenty-two eyes of 22 consecutive patients were included in the study; 11 cases (50%) were treatment naive. Three lesions (14%) were located at the macula, 14 (63%) between the macula and equator, and 5 (23%) between the equator and the ora serrata. The mean tumor base and thickness were, respectively, 10.3 mm (range 5–15 mm) and 4.3 mm (range 1.5–8.9 mm). Seventeen lesions (77%) were dome shaped, whereas 5 (23%) had a mushroom configuration. Thirteen lesions (59%) were pigmented, 5 (23%) partially pigmented, and 4 (18%) amelanotic. An exudative retinal detachment was documented in 13 eyes (59%). Fluorescein angiography and indocyanine green angiography were performed in 20 patients and disclosed intrinsic microvasculature of the tumor, respectively, in 4 (20%) and 20 (100%) cases. Swept-source optical coherence tomography angiography was performed in 22 eyes and detected microvasculature of choroidal melanoma in all cases. Specifically, intrinsic vasculature could be recognized in 14 eyes (64%) using the automated choroid segmentation, 16 eyes (73%) using the automated whole eye segmentation, and in 22 eyes (100%) with fine manual adjustments of segmentation lines.

Conclusion: Swept-source optical coherence tomography angiography represents a valid imaging technique to evaluate patients affected by choroidal melanomas. In our series, SS-OCT-A disclosed the intrinsic microvasculature of the tumor in all cases despite their size, location, and history of previous treatments.

Swept-source optical coherence tomography angiography of 22 eyes with choroidal melanoma disclosed tumor intrinsic microvascularization in all cases.

*Department of Biomedical and Clinical Science “Luigi Sacco,” Eye Clinic, Luigi Sacco Hospital, University of Milan, Milan, Italy; and

Save Sight Institute, Sydney Eye Hospital, University of Sydney, Sydney, Australia.

Reprint requests: Marco Pellegrini, MD, 4th Floor, Building #51, Department of Biomedical and Clinical Sciences “Luigi Sacco,” Eye Clinic, Luigi Sacco Hospital, University of Milan, Italy 20157; e-mail:

None of the authors has any financial/conflicting interests to disclose.

A. Invernizzi has received lecture fees from Allergan. V. Ravera has no financial disclosures. M. G. Cereda has received lecture fees from Bayern and meeting reimbursements from Alcon. G. Staurenghi is a Consultant for Heidelberg engineering, Quantel medical, Centervue, Carl Zeiss Meditec, Alcon, Allergan, Bayer, Boheringer, Genentech, GSK, Novartis, Roche and has received grant support from Optos, Optovue, Centervue. The remaining authors have any financial/conflicting interests to disclose.

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© 2019 by Ophthalmic Communications Society, Inc.