Clinical and imaging feature analysis of choroidal neoplasm

Abstract

Objective To investigate the clinical findings and diagnostic value of MRI,ultrasonography fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) in patients with choroidal neoplasms. Methods In this retrospective study,the clinical data of 22 patients with choroidal neoplasm treated in Zhongshan Ophthalmic Center,Sun Yat-sen University from January 2008 to December 2009 was collected and analyzed.All patients were examined by ultrasound type-B and color Doppler scan.Some of them received FFA,ICGA,CT and MRI examinations.The patients with primary malignant tumor were treated with enucleation.The patients with choroidal metastasis were referred to tumor hospital and usually had systemic chemotherapy and local radiotherapy.The patients with choroidal hemangiomas usually received retinal photocoagulation or photodynamic therapy except those with uncontrolled secondary glaucoma who often had enucleation. Results The imaging of 12 patients with choroidal malignant melanoma showed typical globular or mushroom-shaped intraocular mass with brown or black color.MR1 examination revealed high signal intensities on TlWI and low signal intensities on T2WI.Flat orange-red neoplasm in the posterior pole was the main clinical characteristics of choroidal hemangioma in 7 patients.In the early phase,hyperfluorescence was observed in choroidal hemangioma with FFA/ICGA.MRI revealed low or medium signal intensity on TlWI and high signal intensity on T2WI,with high enhancement.Three cases of choroidal metastasis usually demonstrated flat gray-yellow intraocular mass in posterior pole,all of them had the primary systemic tumor in our case series,and one patient was involved bilaterally. Conclusions The diagnosis of choroidal neoplasm often can be confirmed through detail routine fundus examination in eyes with refractive media transparency.FFA/ICGA is highly valuable in the diagnosis of choroidal hemangioma.MRI and ultrasound examination contributes well to the diagnosis of choroidal neoplasm in eyes with refractive media opacity. Key words: Choroidal neoplasm; MRI; Ultrasonography; Fundus fluorescein angiography; Indocyanine green angiography