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
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AS-OCT OCT imaging anterior segment ocular
structuressuperluminescent light-emitting diode 1310
nanometers wave length 18 microns resolution & 3 to 4 mm penetration
Introduction
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UBMHigh frequency ultrasound 20-50MHzIn 50 MHz mode 25 microns resolution and
5-6mm penetration
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Previous study showed UBM and AS-OCT on the fields of glaucoma
Evaluation of anterior segment tumors using UBM and AS-OCT are rare
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To compare UBM and AS-OCT for imaging tumors of the anterior segment of the eye
AIM
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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
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UBM OPKO instrumentation/OTI was set to 50MHz
AS-OCT Visante OCT 3.0
Methods
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Demographic data included Age Gender
Tumor features Involved tissue Diagnosis Color Thickness Location shape
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UBM & AS-OCT data Acoustic feature Internal tumor pattern Tumor thickness Tumor base Tumor configuration Tumor margins
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Result
200 patients
Age ranging from 2 – 95 yrs
old(mean 50 yrs
old)
74 (37%) Male126 (63%)
female
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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%)
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Opop[
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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%)
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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
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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
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Discussion