White Paper on Ophthalmic Imaging for Choroidal Nevus Identification and Transformation into Melanoma

Shields, Carol L.; Lally, Sara E.; Dalvin, Lauren A; Sagoo, Mandeep S; Pellegrini, Marco; Kaliki, Swathi; Gündüz, Ahmet Kaan; Furuta, Minoru; Mruthyunjaya, Prithvi; Fung, Adrian T.; Duker, Jay S.; Selig, Sara; Yaghy, Antonio; Ferenczy, S; Eydelman, Malvina B.; Blumenkranz, Mark S.

doi:10.1167/tvst.10.2.24

Cited by 24 publications

(15 citation statements)

References 32 publications

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“…Therefore, early diagnosis, monitoring of tumour growth, and follow-up after therapy are indispensable to vision and life. Today, in clinical routine, a broad spectrum of imaging technologies is applied for the best possible care of patients with choroidal melanoma [ 3 , 4 , 5 , 6 ]. Multimodal imaging includes fundus photography, infrared imaging, fundus autofluorescence (FAF) imaging, fluorescein and indocyanine green angiography, ultrasonography, and optical coherence tomography.…”

Section: Introductionmentioning

confidence: 99%

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: Introductionmentioning

confidence: 99%

Fundus Autofluorescence Imaging in Patients with Choroidal Melanoma

Bindewald-Wittich

Holz

Ach

et al. 2022

Cancers

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“…Those subtle features can be used to determine if the vasculature and SRF seen on multimodal imaging is a result of tumour compression of surrounding tissues or a CNV related to the chronicity of the benign lesion. ≤ 20/50, O -orange pigment in autofluorescence, M -melanoma acoustic hollowness in ultrasound examination, DIM -diameter > 5 mm on fundus photography) -very useful in everyday practice [2,4,5]. However, the presence of subretinal fluid may be misleading for unexperienced ophthalmologists if it is associated with RPE changes overlying the nevus.…”

Section: Discussionmentioning

confidence: 99%

“…Choroidal neovascularization related to melanocytic naevus -a single centre study Choroidal naevus is the most common primary melanocytic lesion with the incidence of 2-25% in white Caucasian population [1,2]. It is estimated that about 1 in 8000 naevi can undergo a malignant transformation [3], although it is still not clear whether the naevus stage in the development of malignant melanoma is required.…”

Section: Highlightsmentioning

confidence: 99%

Choroidal neovascularization related to melanocytic naevus – a single centre study

Zwolińska

Rospond-Kubiak

2022

Ophthatherapy

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Purpose: To assess the angiographic and optical coherence tomography angiography (OCTA) features as well as the natural course of the choroidal neovascularization (CNV) associated with choroidal naevi. Setting/venue: Ocular Oncology Service, Department of Ophthalmology, Poznan University of Medical Sciences. Material and methods: Retrospective chart analysis of the patients who presented to the Ocular Oncology Service in Poznan, Poland between 2011–2021 with the diagnosis of suspicious choroidal naevus. In all patients full ophthalmic examination and multimodal imaging, including fundus photography, autofluorescence, B-ultrasound, optical coherence tomography (OCT), OCT angiography (OCTA) and fluorescein angiography (FAF), were performed. Results: There were 9 lesions in 9 patients, 9 women aged 14–79 years (mean age: 58.2 years). All the lesions were located in the posterior pole and most of them were pigmented (88.9%). CNVs associated with choroidal naevi were type I in 66.7% and type II in 33.3% of cases. 5 patients required treatment: anti-VEGF injection (alone or with transpupillary thermotherapy) was administered. The median follow-up was 24 months (range: 2–145). In two of all treated patients (40%), we observed BCVA gain (2–4 lines), in one patient (20%) it remained stable and in two (40%) it deteriorated. The final visual acuity was below 0.1 only in 1 patient. During the period of observation none of the lesions progressed to uveal melanoma. Conclusions: CNV associated with choroidal naevus could be the reason for subretinal fluid (SRF) leakage and visual loss. The response to anti-VEGF treatment is satisfactory in the majority of patients. Choroidal naevi with accompanying CNV have none or very low malignant transformation potential.

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“…Choroidal nevus is the most frequently occurring primary intraocular tumor 1 . This condition poses two associated risks: firstly, a benign nevus can transform into malignant melanoma, with risks of melanoma-related metastasis and mortality; and secondly, nevi may lead to vision impairment from subretinal fluid or secondary choroidal neovascularization 2, 3 . Early detection and careful progression monitoring of choroidal nevi are crucial as they are early-stage precursors to choroidal melanomas 4 .…”

Section: Introductionmentioning

confidence: 99%

Multispectral Fundus Photography of Choroidal Nevi with Trans-Palpebral Illumination

Rahimi,

Rossi,

Son

et al. 2024

Preprint

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Purpose: To investigate the spectral characteristics of choroidal nevi and assess the feasibility of quantifying the basal diameter of choroidal nevi using multispectral fundus images captured with trans-palpebral illumination. Methods: The study employed a widefield fundus camera with multispectral (625 nm, 780 nm, 850 nm, and 970 nm) trans-palpebral illumination. Geometric features of choroidal nevi, including border clarity, overlying drusen, and lesion basal diameter, were characterized. Clinical imagers, including scanning laser ophthalmoscopy (SLO), autofluorescence (AF), and optical coherence tomography (OCT), were utilized for comparative assessment. Results: Fundus images captured with trans-palpebral illumination depicted nevi as dark regions with high contrast against the background. Near-infrared (NIR) fundus images provided enhanced visibility of lesion borders compared to visible light fundus images and SLO images. Lesion-background contrast measurements revealed 635 nm SLO at 11% and 625 nm fundus at 42%. Significantly enhanced contrasts were observed in NIR fundus images at 780 nm (73%), 850 nm (63%), and 970 nm (67%). For quantifying the basal diameter of nevi, NIR fundus images at 780 nm and 850 nm yielded a deviation of less than 10% when compared to OCT B-scan measurements. Conclusion: NIR fundus photography with trans-palpebral illumination enhances nevi visibility and boundary definition compared to SLO. Agreement in basal diameter measurements with OCT validates the accuracy and reliability of this method for choroidal nevi assessment. Translational Relevance: Multispectral fundus imaging with trans-palpebral illumination improves choroidal nevi visibility, accurately measures basal diameter, promising to enhance clinical practices in screening, diagnosis, and monitoring of choroidal nevi.

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White Paper on Ophthalmic Imaging for Choroidal Nevus Identification and Transformation into Melanoma

Abstract: This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Cited by 24 publications

References 32 publications

Fundus Autofluorescence Imaging in Patients with Choroidal Melanoma

Fundus Autofluorescence Imaging in Patients with Choroidal Melanoma

Choroidal neovascularization related to melanocytic naevus – a single centre study

Multispectral Fundus Photography of Choroidal Nevi with Trans-Palpebral Illumination

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