Work

Swept-Source OCT Angiography Features of Melanotic Choroidal Tumors: An Analysis of 102 Consecutive Cases

Year: 2025

Type: article

Abstract: Purpose To quantitatively analyze swept-source optical coherence tomography angiography (SS-OCTA) features of choroidal melanoma and nevi, focusing on their distinguishing angiographic features. Methods This retrospective study included 102 consecutive patients with choroidal melanoma or nevi referred to Beijing Tongren Hospital between July 2019 and June 2024. The choriocapillaris and choroid slabs were en face reconstructed. A five-grade system was developed based on the density and morphology of disorganized vasculature in the choroid slab. choriocapillaris flow void (CCFD%) was calculated within circular regions defined by the tumor's radius and diameter. Results Of all 102 patients, 87 (85%) patients with qualified SS-OCT images, comprising 61 cases of choroidal melanoma and 26 cases of nevi. Sixty melanoma cases (98%) exhibited disorganized tumor vasculature forming twisted vessel loops and networks on the choroid slab (Grade 2 or above). Nevi showed two types of intrinsic tumor vasculature pattens in the choroidal slab: well-organized (Grade 0 or 1) and melanoma-like disorganized networks (Grade 2 or higher). Classified based on multimodal imaging risk score, nevi with a high risk for growth (≥ 2 risk factors) were more likely to exhibit melanoma-like disorganized networks tumor vasculature (82% vs. 27%, P =0.015) than low-risk nevi. Analysis of the choriocapillaris slab revealed a higher prevalence of patchy avascular areas in melanomas compared to nevi. The CCFD% was significantly higher in choroidal melanomas than in nevi within circular regions defined by the tumor's radius (56.4% vs. 34.4%, P<0.001) and diameter (44.9% vs. 23.4%, P<0.001). Conclusions SS-OCTA enables detailed, noninvasive assessment of intrinsic vasculature in melanotic choroidal tumors.

Source: Ophthalmology Science

DOI: 10.1016/j.xops.2025.100932