Colour imaging in the monitoring and documentation of choroidal naevi. Are Optomap colour images adequate for this purpose?

Abstract

An audit project to evaluate and compare three different imaging systems used to photograph choroidal naevi and to determine whether the Optos Optomap(®) can be used as the only colour image capture system for monitoring and documenting choroidal naevi. A further aim was to assess whether existing protocols could be improved to accurately document position and appearance of choroidal naevi. Twenty patients with choroidal naevi were photographed on three different colour image capture systems. Colour images were taken on the Optomap(®) wide field P200MA camera; the Zeiss FF450plus(®) mydriatic camera and the Topcon TRC-NW6S(®). All images were reviewed retrospectively by a medical retina consultant (SD) who completed a questionnaire to determine the most effective photographic system(s) in demonstrating the location of the naevi and the features of the condition. The Optomap(®) was the most effective in pinpointing the location of the naevus and the Zeiss FF450plus mydriatic camera best captured the features of the naevus. The non-mydriatic camera was rated the least satisfactory for both tasks. The location of the naevus on the retina should determine the choice of modality. If it is possible to photograph the lesion and include the optic disc or central macula, then the mydriatic camera is considered the best modality for recording both the position and features of the pathology. However, if it is not possible, because of the location, to include both the disc or central macula with the lesion in the same frame, then the Optomap(®) should be used to photograph the naevus to record its position and ideally a colour image on the mydriatic camera should also be taken to record the appearance of the lesion.

Can the MOLES acronym and scoring system improve the management of patients with melanocytic choroidal tumours?

“…The entire tumour margin should be assessed because lateral extension may not occur in the same axis of the largest basal diameter. Furthermore, photographic distortion can give a false impression of growth [ 21 ]. According to Jouhi et al, the basal diameter of melanomas tends to increase by approximately 34% per year as compared to 1% in naevi [ 20 ].…”

Widefield imaging of retinal and choroidal tumors

“…One review recommended capturing both the optic disc and macula in the same image as the nevus to create a baseline comparison color. If this is not possible than a standard fundus photo with true color may be additionally beneficial [12]. Choroidal nevi confer a 1 in 8000 risk of transformation into malignant melanoma and a lifetime risk of growth of approximately 1%.…”