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Autofluorescence of choroidal melanoma in 51 cases

Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, PA, USA

Correspondence to:
Dr C L Shields, Ocular Oncology Service, Suite 1440, Wills Eye Institute, 840 Walnut Street, Philadelphia, PA 19107, USA; carol.shields{at}shieldsoncology.com

Aim: To describe the autofluorescence features of choroidal melanoma.

Design: Non-comparative case series.

Participants: 51 consecutive patients.

Methods: Standard fundus photography and autofluorescence photography (580 nm excitation, 695 nm barrier filter) were performed on all patients. Clinical features were correlated with autofluorescence features.

Main outcome measure: Autofluorescence features of choroidal melanoma and overlying retinal pigment epithelium (RPE).

Results: The mean patient age was 59 years. The choroidal melanoma was a mean of 3.6 mm from the optic disc and 2.6 mm from the foveola. The mean tumour basal dimension was 11 mm and the mean tumour thickness was 4 mm. The choroidal melanoma showed intrinsic hypoautofluorescence (39%), isoautofluorescence (6%) and hyperautofluorescence (55%). Slightly increased hyperautofluorescence of the melanoma was found in pigmented tumours (versus non-pigmented), those with greater thickness and basal dimensions, and those with overlying disrupted RPE. Related RPE hyperplasia and atrophy showed hypoautofluorescence, drusen, RPE detachment and subretinal fluid showed slight hyperautofluorescence, and orange pigment displayed the brightest hyperautofluorescence.

Conclusions: Choroidal melanoma generally shows slight intrinsic hyperautofluorescence and the brightness increases with pigmented tumours, larger tumours, and those associated with disrupted RPE. Overlying orange pigment shows remarkably bright hyperautofluorescence.

Funding: Support provided by the Retina Research Foundation of the Retina Society in Cape Town, South Africa to CLS), the Paul Kayser International Award of Merit in Retina Research, Houston, TX (to JAS), a donation from Michael, Bruce, and Ellen Ratner, New York, NY (to JAS, CLS), Mellon Charitable Giving from the Martha W Rogers Charitable Trust, Philadelphia, PA (to CLS), the LuEsther Mertz Retina Research Foundation, New York, NY (to CLS), and the Eye Tumour Research Foundation, Philadelphia, PA (to CLS, JAS). The sponsors did not participate in the design or conduct of this study, in the collection, analysis or interpretation of the data, or in the preparation, review or approval of the manuscript.

Competing interests: None declared.

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