Choroidal pigmented lesions imaged by ultra-wide-field scanning laser ophthalmoscopy with two laser wavelengths (Optomap)
Choroidal pigmented lesions imaged by ultra-wide-field scanning laser ophthalmoscopy with two laser wavelengths (Optomap)
复制标题
使用两种激光波长的超广角扫描激光检眼镜成像的脉络膜色素病变（Optomap）
作者：
M. Kernt;U. Schaller;C. Stumpf;M. Ulbig;A. Kampik;A. Neubauer
目的：脉络膜色素性病变的临床鉴别有时很困难。脉络膜黑色素瘤是眼部恶性肿瘤中最常见的原发性肿瘤，在原发性肿瘤被诊断出来之前就已经发生转移。因此，早期发现至关重要。我们研究了临床诊断的黑色素细胞脉络膜肿瘤的成像特性，使用非散瞳超宽场扫描激光检眼镜（SLO）与两个激光波长，以区分良性和恶性病变。重复的标准化超声（US）评价提供了参考标准。研究方法：在49例单眼临床诊断为黑色素细胞脉络膜肿瘤的患者的连续系列中，29例已确定黑色素瘤（定义为重复US随访时证实生长），20例有痣（定义为根据临床、US和生长特征至少2年无恶性肿瘤）。所有患者均接受临床检查、未扩张的Optomap®（Optos PLC，Dunfermline，Fife，Scotland，UK）成像、标准化US检查和标准视网膜摄影。使用Optomap软件测量肿瘤基底与US B扫描测量进行比较。两组患者的SLO影像学特征与结构性改变相关。结果：SLO和US的肿瘤基底测量值之间具有良好的相关性，r = 0.61（T方向）和r = 0.51（L方向）。在SLO成像上，典型的恶性病变在红色激光通道上显示为暗，而在绿色激光通道上显示为亮。基于这些简单的二元特征，获得了76%的敏感性和70%的特异性，用于正确的病变分类。当类似于临床检查病变大小，边缘接触视盘，视网膜下液的存在，另外考虑，获得90%的灵敏度和82%的特异性。结论：在这第一个，有限的系列，非散瞳SLO成像与两个激光波长允许区分恶性肿瘤与非恶性病变的诊断准确性高。其他参数可能会进一步增强诊断性能，但需要更大的患者系列来验证我们的研究结果并证明诊断性能。
Purpose: Clinical differentiation of choroidal pigmented lesions is sometimes difficult. Choroidal melanoma is the most prevalent primary neoplasia among malignant ocular tumors, and metastasis often occurs before the primary tumor is diagnosed. Therefore, early detection is essential. We investigated the imaging properties of clinically diagnosed melanocytic choroidal tumors using a nonmydriatic ultra-wide-field scanning laser ophthalmoscope (SLO) with two laser wavelengths to distinguish benign from malignant lesions. Repeated standardized ultrasound (US) evaluation provided reference standard. Methods: In a consecutive series of 49 patients with clinically diagnosed melanocytic choroidal tumors in one eye, 29 had established melanoma (defined by proven growth on repeated US follow-up) and 20 had nevi (defined by no malignancy according to clinical, US, and growth characteristics for at least 2 years). All patients underwent clinical examination, undilated Optomap® (Optos PLC, Dunfermline, Fife, Scotland, UK) imaging, standardized US examination, and standard retinal photography. Measurements of the tumor base using the Optomap software were compared with US B-scan measurements. Imaging characteristics from the SLO images were correlated with the structural findings in the two patient groups. Results: Measurements of tumor base correlated well between SLO and US with r = 0.61 (T-direction) and r = 0.51 (L-direction). On SLO imaging, typical malignant lesions appeared dark on the red laser channel and bright on the green laser channel. Based on those simple binary characteristics, a sensitivity of 76% at a specificity of 70% was obtained for a correct classification of lesions. When analogous to clinical examination lesion size, margin touching the optic disc, and existence of subretinal fluid were additionally considered, 90% sensitivity at 82% specificity was obtained. Conclusions: In this first, limited series, nonmydriatic SLO imaging with two laser wavelengths permitted to differentiate malignant ocular tumors from nonmalignant lesions with high diagnostic accuracy. Additional parameters may further enhance diagnostic properties, but larger patient series are required to validate our findings and prove the diagnostic properties.
16 个月内重新出现的黑色素瘤。
DOI：
10.1001/archopht.1988.01060130407031
发表时间：
1988
期刊：
Archives of ophthalmology (Chicago, Ill. : 1960)
影响因子：
--
作者：
Sahel,JA;Pesavento,R;FrederickJr,AR;Albert,DM
通讯作者：
Albert,DM