In vivo optical biopsy of choroidal osteoma: a swept source optical coherence tomography–based tumor characterization
Shorya Vardhan AzadВинод КумарRohan ChawlaBibhuti KashyapShreyas TemkarAtul KumarPradeep VenkateshRajpal VohraKabiruddin MollaAnu Sharma
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To study tumor characteristics of choroidal osteoma by swept source optical coherence tomography.A retrospective case series done at tertiary referral center in northern India. All patients diagnosed with choroidal osteoma examined on swept source optical coherence tomography were included. Swept source optical coherence tomography images were analyzed for integrity of retinal layers-intraretinal layers, outer retinal layers (photoreceptor), retinal pigment epithelium, and contour abnormalities. Choroidal changes assessed were tumor attributes such as shape, depth of choroidal involvement, tumor mass reflectivity pattern, tumor vascularity, and evolutionary structural abnormalities such as deossification, focal depressions, or choroidal neovascular membrane.A total of 15 eyes of 11 patients were analyzed. Seven of 11 patients were females. Mean age of presentation was approximately 26 years. Tumor was large in nine cases (>7.5 mm). Deossification was seen in 12 eyes. Inner and outer retinal integrity was maintained in 7 and 2 eyes, respectively. Most common internal tumor reflectivity pattern seen was a lamellar appearance (12/15). Increased signal transmission to choroid and focal area of deep excavation was present in 11 and 4 eyes, respectively. Osteoclastic activity was noted in 12 eyes. Choroidal neovascular membrane was seen in 6 eyes. Small lesions showed lamellar pattern of tumor reflectivity with preservation of retinal pigment epithelium and overlying retina. Larger tumors were deossified with 6 irregular tumor contour, disorganization of the outer retina, increased signal transmission to choroid, and areas of osteoclastic activity.Swept source optical coherence tomography was helpful in assessing tumor attributes and predicting the different timelines in tumor evolution.Keywords:
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Purpose. To evaluate the effectiveness of the retinal pigment epithelium and choroid autotranslocation performed for traumatic rupture of the choroid in the macular area. Material and methods. A 30-year-old patient with subretinal fibrosis due to traumatic rupture of the choroid in the macular area underwent subretinal surgery with retinal pigment epithelium and choroid autotranslocation. Visual acuity and morphological status were assessed according to optical coherence tomography and ophthalmoscopy. The observation period is 12 months. Results. No side effects and complications were detected during the entire observation period. Visual acuity increased from 0.05 initially to 0.15 by the end of the observation period. The RPE-choroid graft is located in the macular area without signs of exudation and fibrosis, the fovea is in the center of the retinal pigment epithelium – choroid graft, the pigment epithelium is viable. Conclusion. Subretinal surgery with retinal pigment epithelium and choroid autotranslocation is the method of choice in the treatment of post-traumatic rupture of the choroid in the macular area, that can lead to a significant improvement in visual functions. Keywords: Subretinal surgery, vitreo-retinal surgery, choroid rupture, silicone oil, autotranslocation.
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The Authors were able to observe histologically the lesions induced by Argon-laser on the retina and choroid of two eyeballs that afterwards were enucleated because they developed choroid melanoma. The observations have been respectively made 10, 20 and 40 days after the beginning of the treatment and a progressive structural overturning of the retina and the choroid due to the obstruction of choriocapillary vessels, to the tendency to fusion of the various nuclear layers as well as to the connection of the layer of nerve fibres, has been observed.
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