Changes in fundus autofluorescence of choroidal melanomas following treatment

Amselem, Luis; Pulido, José S.; Günduz, Kaan; Bakri, Sophie J.; Díaz-Llópis, Manuel; Dolan, Joseph W.; Morgan, Katie M.; Souza, S De; Link, Thomas P.; Rosvold, Jake

doi:10.1038/sj.eye.6703004

Cited by 8 publications

(4 citation statements)

References 16 publications

(17 reference statements)

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“…Similar results were reported by Amselem et al following plaque radiotherapy in two patients and combined plaque radiotherapy and transpupillary thermotherapy in six patients with a mean follow-up of 4 months (range 2–9 months) [ 88 ]. The authors confirm the usefulness of FAF imaging to detect orange pigment and an increased FAF intensity after therapy.…”

Section: Choroidal Melanomasupporting

confidence: 87%

Fundus Autofluorescence Imaging in Patients with Choroidal Melanoma

Bindewald-Wittich

Holz

Ach

et al. 2022

Cancers

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Choroidal melanocytic lesions require reliable and precise clinical examination and diagnosis to differentiate benign choroidal nevi from choroidal melanoma, as the latter may become life-threatening through metastatic disease. To come to an accurate diagnosis, as well as for monitoring, and to assess the efficacy of therapy, various imaging modalities may be used, one of which is non-invasive fundus autofluorescence (FAF) imaging using novel high-resolution digital imaging technology. FAF imaging is based on the visualization of intrinsic fluorophores in the ocular fundus. Lipofuscin and melanolipofuscin within the postmitotic retinal pigment epithelium (RPE) cells represent the major fluorophores that contribute to the FAF signal. In addition, the presence or loss of absorbing molecular constituents may have an impact on the FAF signal. A choroidal melanoma can cause secondary retinal and RPE alterations that affect the FAF signal (e.g., occurrence of orange pigment). Therefore, FAF imaging supports multimodal imaging and gives additional information over and above conventional imaging modalities regarding retinal metabolism and RPE health status. This article summarises the features of FAF imaging and the role of FAF imaging in the context of choroidal melanoma, both before and following therapeutic intervention.

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Section: Choroidal Melanomasupporting

confidence: 87%

Fundus Autofluorescence Imaging in Patients with Choroidal Melanoma

Bindewald-Wittich

Holz

Ach

et al. 2022

Cancers

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“…To date little insight exists into FAF changes after brachytherapy for choroidal melanomas. Following plaque radiotherapy and/or transpupillary thermotherapy, former reports describe an increased FAF signal in association with orange pigment and hyperpigmentation [46,47]. In contrast, this study aims to assess FAF changes in the irradiation field especially towards the central border of the ruthenium-106 plaque and outside pre-existing chronic changes at the tumour apex to identify FAF characteristics and their quasi-histological correlate in OCT for monitoring effects of RBT.…”

Section: Introductionmentioning

confidence: 99%

Blue-Light Fundus Autofluorescence Imaging following Ruthenium-106 Brachytherapy for Choroidal Melanoma

et al. 2020

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To describe changes in blue-light fundus autofluorescence (FAF) and corresponding alterations in optical coherence tomography (OCT) within the irradiation field after ruthenium-106 brachytherapy (RBT) for choroidal melanoma. Methods: Consecutive patients with choroidal melanoma were included in a retrospective case series. Patients were treated with RBT at a single institution. As part of their routine examination patients underwent multimodal imaging including ultrasonography, fundus photography, OCT, and FAF imaging (excitation = 488 nm). FAF images were analysed for changes within the irradiation field. Results: 31 patients (mean age 65.7 years) were treated with RBT for unilateral choroidal melanoma. Mean tumour height before therapy was 2.7 mm (SD 1.0). Mean follow-up time was 23.3 months (SD 13.3). Main FAF characteristics attributable to RBT emerged as increased FAF with speckled decreased FAF (FAF mottling) within the irradiation field and a rim of increased FAF at its border. OCT scans demonstrated loss of the ellipsoid zone and the external limiting membrane, thinning of the neurosensory retina, and alterations of the retinal pigment epithelium like clumping, migration, and atrophy. Conclusions: FAF changes in the irradiation field after RBT of choroidal melanomas follow a characteristic pattern that correlates with distinct OCT alterations. FAF and OCT imaging give additional information to monitor effects of RBT and, therefore, complement multimodal imaging techniques after plaque therapy.

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“… 1 Although it has been observed clinically that orange pigment overlying choroidal melanocytic lesions is an important sign of malignant choroidal melanomas, the cells that produce the orange pigment are unknown. 2 …”

Section: Introductionmentioning

confidence: 99%

Histopathologic Findings in the Areas of Orange Pigment Overlying Choroidal Melanomas

García

Salomão

Marmorstein

et al. 2016

Trans. Vis. Sci. Tech.

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PurposeOrange pigment is an important sign of malignancy in melanocytic tumors. There is a question as to whether the pigment accumulation is inside of macrophages or retinal pigment epithelial (RPE) cells. We investigated which cells are involved with this color alteration.MethodsWe examined enucleated specimens from two patients with choroidal melanoma and dense orange pigment on fundus examination. Color fundus and fundus autofluorescence (FAF) photographs were reviewed followed by examination with fluorescent microscopy, electron microscopy, and immunohistochemistry of enucleated eyes for the specific areas corresponding to the orange pigment.ResultsOrange pigment was observed on color fundus photography and correlated with areas of hyperautofluorescence on FAF. Fluorescent microscopy of sections of the enucleated eyes showed autofluorescence in the RPE, which were most pronounced where there was a localized retinal detachment and reactive hyperplasia of the RPE. Immunohistochemical studies were done with keratin (OSCAR and AE1/AE3) and S-100 stained RPE cells, which still were attached to Bruch's membrane. Histiocytes present in the detached retina stained with anti-CD163 antibody and did not show autofluorescence. Electron microscopy studies of the same areas showed the presence of lipofuscin and melanolipofuscin within the clustered RPE cells.ConclusionsOrange pigment in choroidal melanocytic lesions originates from the RPE cells, rather than macrophages, and is most abundant where there is proliferation of the RPE.Translational RelevanceThe orange pigment tumoral biomarker arises and is in the retinal pigment epithelium.

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Changes in fundus autofluorescence of choroidal melanomas following treatment

Cited by 8 publications

References 16 publications

Fundus Autofluorescence Imaging in Patients with Choroidal Melanoma

Fundus Autofluorescence Imaging in Patients with Choroidal Melanoma

Blue-Light Fundus Autofluorescence Imaging following Ruthenium-106 Brachytherapy for Choroidal Melanoma

Histopathologic Findings in the Areas of Orange Pigment Overlying Choroidal Melanomas

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