Possible role of standardized echography complementing ultrasound biomicroscopy in tumors of the anterior eye segment: a study in a series of 13 patients

Abstract

To evaluate the efficacy of standardized A-scan echography (ASE) complementing ultrasound biomicroscopy (UBM) to propose the most efficient method as grounds for the diagnosis, treatment, and follow-up of anterior eye-segment tumors. The inclusion criteria were tumors of the ciliary body and peripheral choroidal tumors, whose anterior border could not be visualized with a 10MHz ultrasound probe. The largest basal dimension and the highest prominence of the tumor were measured with a UBM Lin 50 probe. A standardized A-scan examination determined the tumor's thickness and internal reflectivity. Thus, tissue differentiation led to a standardized echography-based diagnosis (SED). The study included 13 patients. SED was achieved in all examined tumors. The smallest thickness of the tumor of the ciliary body enabling SED was only 1.78mm. The highest prominence of the tumor (3.66 ± 1.39mm) was generally larger than its thickness (3.30 ± 1.71mm). When approaching ciliary body tumors, both ASE and UBM should be performed, the former to accurately differentiate the tumor and measure its height, and the latter to delineate anterior tumor margins and iris involvement. Standardized echography-based diagnosis was grounds for further evaluation and/or treatment in this case series. The highest prominence of the ciliary body tumor perpendicular to the sclera as evidenced by UBM was generally higher than the thickness obtained with standardized echography. Hence, we propose ASE thickness to be the grounds for staging the severity of ciliary body tumors in the algorithm for their management.