Дифференциальная диагностика невусов и меланом хориоидеи по данным ОКТ

Abstract

The article presents the study results of 64 patients with suspicious (progressive) nevi (n = 42) and initial choroid melanomas (n = 22, of which n = 3 had anamnesis of choroid nevus). Ultrasound examination, digital photoregistration of the fundus and OCT were done for all patients. According to the OCT data it was possible to identify diagnostic criteria that help distinguish of suspicious nevi including those with a high risk of malignant transformation from initial choroid melanomas. First of all these are the preservation of the Bruch membrane and the presence of druses. While malignant transformation of suspicious nevi was characterized by shape asymmetry of the enlarged “choroidal complex”, dilation of large choroidal vessels around the nevus, the presence of RPE detachment and the presence of hyperreflective intraretinal inclusions. Criteria of initial choroid melanomas were violation of the integrity of the Bruch membrane, rounded cavities in the inner layers of the choroid, deposits at the level of RPE, edema and/or rupture of the photoreceptor layer. Keywords: suspicious choroid nevus, choroid melanoma, OCT