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Clinical imaging and high-resolution ultrasonography in melanocytoma management
Case Series
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Authors: Daniel Gologorsky, Amy C Schefler, Fiona J Ehlies, et al
Published Date July 2010
Volume 2010:4 Pages 855 - 859
DOI: http://dx.doi.org/10.2147/OPTH.S11891
Daniel Gologorsky1, Amy C Schefler2, Fiona J Ehlies2, Paul A Raskauskas3, Yolanda Pina2, Basil K Williams Jr4, Timothy G Murray21Dartmouth Medical School, Hanover, New Hampshire; 2Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; 3Retina Consultants of Southwest Florida, Fort Myers, Florida; 4Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
Purpose: To demonstrate the utility of high resolution 20 MHz ophthalmic ultrasound in serial follow-up of optic nerve head melanocytoma patients.
Methods: This study is a retrospective review of 30 patients with melanocytoma of the optic nerve head studied with echography. All patients were evaluated with standard ophthalmic A-scan and B-scan ultrasonography and 10 (33%) underwent high-resolution ultrasound.
Results: Sixty-two percent (62%) of patients had dome-shaped lesions on ultrasound, twenty-eight percent (28%) presented with mild elevations. The maximum elevation of any lesion was 2.6 mm. The vast majority (89%) of lesions had medium or high internal reflectivity and 89% demonstrated avascularity. Mean follow-up for all patients was nearly 7 years. High-resolution ultrasound enabled enhanced accuracy for detection of lesion dimensions and documentation of growth and possible malignant transformation.
Conclusions: In this study, we demonstrate a new and important role for the use of ultrasound in this disease as a complementary tool in identifying and following patients with high-risk growth characteristics. These tumor characteristics can be accurately detected with 10 MHz ultrasound in conjunction with standardized A-scan and better differentiated with the 20 MHz technology. Use of these modalities can aid in distinguishing the melanocytomas that grow from choroidal melanomas and can prevent unnecessary treatments.
Keywords: imaging, high-resolution, ultrasonography, melanocytoma
Other articles by Professor Timothy G. Murray
Advanced retinoblastoma treatment: targeting hypoxia by inhibition of the mammalian target of rapamycin (mTOR) in LHBETATAG retinal tumorsCan children undergoing ophthalmologic examinations under anesthesia be safely anesthetized without using an IV line?
Concomitant bilateral intravitreal anti-VEGF injections for the treatment of exudative age-related macular degeneration
Evaluation of economic efficiencies in clinical retina practice: activity-based cost analysis and modeling to determine impacts of changes in patient management
Novel retinoblastoma treatment avoids chemotherapy: the effect of optimally timed combination therapy with angiogenic and glycolytic inhibitors on LHBETATAG retinoblastoma tumors
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