[Role of optical coherence tomography angiography in diagnostics of early choroidal melanoma and circumscribed choroidal hemangioma].

Unlabelled: Small choroidal melanoma is a malignant tumor that is prone to early metastasis, its amelanotic form is often similar to circumscribed choroidal hemangioma. The main attribute for tumor identification is its vascularization, which is the target of various examination methods. Optical coherence tomography angiography (OCTA) has not been previously used in complex diagnostics of early choroidal melanoma and circumscribed choroidal hemangioma for detection of tumor vessels and the nature of their branching, as well as for vessel caliber comparison. Purpose to examine vascularization of early uveal melanoma and circumscribed choroidal hemangioma by optical coherence tomography angiography.

Material And Methods: The study included 23 patients with early choroidal melanoma (13 subjects) and circumscribed choroidal hemangioma (10 subjects) that were examined by optical coherence tomography angiography. According to ultrasound investigation, mean tumor prominence was 1.1±0.3 mm, mean base diameter - 8.1±0.6 mm.

Results: Optical coherence tomography angiography in 13 patients with small choroidal melanoma revealed presence of a neovascular component localized under retinal pigment epithelium (RPE) that had marginal avascular zone corresponding to the tumor slope. The loop-like shape of tumor vessels with numerous twists and interweaving was noted under retinal vessels. A tree-shaped neovascular component with large-caliber vessels in the form of a tree trunk with multiple branches extending from it was seen under RPE in 4 cases with circumscribed choroidal hemangioma; diffuse vascularization in the form of numerous tiny tortuous vascular branches was seen in 6 patients.

Conclusion: Optical coherence tomography angiography allows detection of tumor`s own vessels with characteristics of their vascularization in early choroidal melanoma and circumscribed choroidal hemangioma. Increasing the frequency of detection of tumor`s own vessels will make possible early differential diagnostics of a malignant or benign tumor and will help establish adequate conserving therapy.