assessment of anterior segment tumors
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Assessment of Anterior Segment Tumorswith
Ultrasound Biomicroscopy versus
Anterior Segment Optical CoherenceTomography in 200 Cases
dr. R.M. Irsan
Source:Carlos Bianciotto et al:Ophthalmology 2011;118:1297–1302
Ophthalmology DepartmentSriwijaya University Faculty of Medicine
dr. Muhammad Hoesing Hospital Palembang2011
Journal reading
AS-OCT OCT imaging anterior segment ocular
structuressuperluminescent light-emitting diode 1310
nanometers wave length 18 microns resolution & 3 to 4 mm penetration
Introduction
UBMHigh frequency ultrasound 20-50MHzIn 50 MHz mode 25 microns resolution and
5-6mm penetration
Previous study showed UBM and AS-OCT on the fields of glaucoma
Evaluation of anterior segment tumors using UBM and AS-OCT are rare
To compare UBM and AS-OCT for imaging tumors of the anterior segment of the eye
AIM
200 patient with anterior segment tumors scanned with both AS-OCT and UBM on the Oncology service, Wills Eye Institute, Philadelphia between June 2008 – March 2010
Methods
UBM OPKO instrumentation/OTI was set to 50MHz
AS-OCT Visante OCT 3.0
Methods
Demographic data included Age Gender
Tumor features Involved tissue Diagnosis Color Thickness Location shape
UBM & AS-OCT data Acoustic feature Internal tumor pattern Tumor thickness Tumor base Tumor configuration Tumor margins
Result
200 patients
Age ranging from 2 – 95 yrs
old(mean 50 yrs
old)
74 (37%) Male126 (63%)
female
Eye involvements
Iris stroma 96 eyes (48%)
IPE 44 eyes (22%)
Iris and ciliary body 32 eyes (16%)
Ciliary body 14 eyes (7%)
Conjunctiva 6 eyes (3%)
Sclera 4 eyes (2%)
Ciliary body+choroid 2 eyes (1 %)
iris+ciliary body+choroid 2 eyes (1%)
Opop[
Imaging comparisonVisibility of tumor margins
• Equal on anterior margins ( 90% vs 82%)• Favorable UBM on posterior margin (90%
vs 29%)• All tumor margins were well visualized with
UBM 95%• Tumor shadowing rarely found on UBM
(5%) but more on AS-OCT (72%)
In general, UBM was more favorable for resolution of the posterior margin of the lesion and for structures from the pigment epithelium posteriorly, whereas AS-OCT was more favorable for anterior margin and ocular structures anterior to the IPE
Overall, UBM was more favorable for complete tumor resolution in IPE cyst and iris melanoma, and both UBM and AS-OCT were equivalent for iris nevus
Discussion
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