Widefield imaging of retinal and choroidal tumors

Abstract

BackgroundWide-field imaging plays an increasingly important role in ocular oncology clinics. The purpose of this review is to describe the commonly used wide-field imaging devices and review conditions seen in ocular oncology clinic that underwent wide-field imaging as part of the multimodal evaluation.Summary of reviewWide-field or wide-angle imaging is defined as greater than 50° field of view. Modern devices can reach far beyond this reporting fields of view up to 267°, when utilizing montage features, with increasingly impressive resolution. Wide-field imaging modalities include fundus photography, fluorescein angiography (FA), fundus autofluorescence (FAF), indocyanine angiography (ICG), spectral domain optical coherence tomography (SD-OCT), and recently wide-field OCT Angiography (OCTA). These imaging modalities are increasingly prevalent in practice. The wide-field systems include laser, optical, and lens based systems that are contact or non-contact lens systems each with its own benefits and drawbacks. The purpose of this review is to discuss commonly used wide-field imaging modalities for retinal and choroidal tumors and demonstrate the use of various widefield imaging modalities in select ocular oncology cases.ConclusionsClinical examination remains the gold standard for the evaluation of choroidal and retinal tumors. Wide-field imaging plays an important role in ocular oncology for initial documentation, surgical planning, determining the relationship of the tumor to adjacent ocular structures, following tumor size after treatment, and monitoring for recurrence.

Comparison of Current Optical Coherence Tomography Angiography Methods in Imaging Retinal Hemangioblastomas

“…We were able to show that both current OCTA technologies, SD-OCTA and SS-OCTA, were almost equally suitable to detect and measure the tumor size of RCHs than is possible with current imaging methods. 21 Tumor size of RCHs, tumor location (juxtapapillary or peripheral), and the location within the retina as well as associated findings (such as extent of subretinal fluid or retinal traction) are all important factors in the choice of treatment for RCHs. 13 Various treatment modalities have been described for peripheral RCHs.…”

“…We were able to show that both current OCTA technologies, SD-OCTA and SS-OCTA, were almost equally suitable to detect and measure the tumor size of RCHs than is possible with current imaging methods. 21 …”

A practical guide to optical coherence tomography angiography interpretation

“…When the macular scan does not capture desired pathology, internal fixation targets can be moved to visualize different sectors of the posterior pole. For example, in the case of choroidal hemangiomas, lesions often occur far from the macula and might be missed by a macular scan [ 32 ]. Moving internal fixation targets, and employing external fixation targets when necessary, can help imaging technicians capture more peripheral lesions.…”

Detecting Progression of Melanocytic Choroidal Tumors by Sequential Imaging: Is Ultrasonography Necessary?

“…Over the last two decades, tremendous advances in both the resolution and speed of optical coherence tomography (OCT) imaging, coupled with its non-invasive nature, have led to its widespread adoption [ 20 , 21 ]. Similarly, wide-field imaging modalities, including fundus autofluorescence, are being used increasingly to aid in the identification of lipofuscin [ 22 ]. When used in combination with various other multi-modal imaging techniques, a great deal of information can be gathered.…”