Optical Coherence Tomography Angiography Characteristics of Iris Melanocytic Tumors

Skalet A, Li Y, Lu CD, Jia Y, Lee B, Husvogt L, Maier A, Fujimoto JG, Thomas CR, Huang D (2017)

Publication Language: English

Publication Type: Journal article, Original article

Publication year: 2017

Journal

Ophthalmology Elsevier

Publisher: Elsevier Inc.

Book Volume: 124

Pages Range: 197-204

Journal Issue: 2

URI: https://www.sciencedirect.com/science/article/pii/S0161642016313288#!

DOI: 10.1016/j.ophtha.2016.10.003

Abstract

Purpose

To evaluate tumor vasculature with optical coherence tomography angiography (OCTA) in malignant iris melanomas and benign iris lesions.

Design

Cross-sectional observational clinical study.

Participants

Patients with iris lesions and healthy volunteers.

Methods

Eyes were imaged using OCTA systems operating at 1050- and 840-nm wavelengths. Three-dimensional OCTA scans were acquired. Iris melanoma patients treated with radiation therapy were imaged again after I-125 plaque brachytherapy at 6 and 18 months.

Main Outcome Measures

OCT and OCTA images, qualitative evaluation of iris and tumor vasculature, and quantitative vessel density.

Results

One eye each of 8 normal volunteers and 9 patients with iris melanomas or benign iris lesions, including freckles, nevi, and an iris pigment epithelial (IPE) cyst, were imaged. The normal iris has radially oriented vessels within the stroma on OCTA. Penetration of flow signal in normal iris depended on iris color, with best penetration seen in light to moderately pigmented irides. Iris melanomas demonstrated tortuous and disorganized intratumoral vasculature. In 2 eyes with nevi there was no increased vascularity; in another, fine vascular loops were noted near an area of ectropion uveae. Iris freckles and the IPE cyst did not have intrinsic vascularity. The vessel density was significantly higher within iris melanomas (34.5%±9.8%, P < 0.05) than in benign iris nevi (8.0%±1.4%) or normal irides (8.0%±1.2%). Tumor regression after radiation therapy for melanomas was associated with decreased vessel density. OCTA at 1050 nm provided better visualization of tumor vasculature and penetration through thicker tumors than at 840 nm. But in very thick tumors and highly pigmented lesions even 1050-nm OCTA could not visualize their full thickness. Interpretable OCTA images were obtained in 82% of participants in whom imaging was attempted.

Conclusions

This is the first demonstration of OCTA in iris tumors. OCTA may provide a dye-free, no-injection, cost-effective method for monitoring a variety of tumors, including iris melanocytic lesions, for growth and vascularity. This could be helpful in evaluating tumors for malignant transformation and response to treatment. Penetration of the OCT beam remains a limitation for highly pigmented tumors, as does the inability to image the entire iris in a single field.

Authors with CRIS profile

Lennart Husvogt Lehrstuhl für Informatik 5 (Mustererkennung) Andreas Maier Lehrstuhl für Informatik 5 (Mustererkennung)

Involved external institutions

Oregon Health and Science University (OSHU) US United States (USA) (US) Massachusetts Institute of Technology (MIT) US United States (USA) (US)

How to cite

APA:

Skalet, A., Li, Y., Lu, C.D., Jia, Y., Lee, B., Husvogt, L.,... Huang, D. (2017). Optical Coherence Tomography Angiography Characteristics of Iris Melanocytic Tumors. Ophthalmology, 124(2), 197-204. https://doi.org/10.1016/j.ophtha.2016.10.003

MLA:

Skalet, Alison, et al. "Optical Coherence Tomography Angiography Characteristics of Iris Melanocytic Tumors." Ophthalmology 124.2 (2017): 197-204.

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