Comparisons of choroidal nevus measurements obtained using 10- and 20-MHz ultrasound and spectral domain optical coherence tomography.

PURPOSE:: To compare measurements of lesions clinically diagnosed as choroidal nevi using spectral domain optical coherence tomography (SD-OCT) and 10- and 20-MHz ultrasound (US). METHODS:: This prospective study, which was conducted between May 2011 and December 2011, evaluated eyes diagnosed with choroidal nevus via photographic documentation using 10- or 20-MHz A- and B-mode US (experienced examiner using both the transpalpebral technique and direct contact) or SD-OCT in the enhanced depth imaging mode (performed by a different examiner blinded to the US results). Anteroposterior (AP) and transverse (T) US sections corresponded to sections adjusted perpendicularly on SD-OCT. RESULTS:: We evaluated 14 eyes from 12 patients (six males, mean patient age= 64.5 years) diagnosed with choroidal nevus. The choroidal nevi of all samples had a melanocytic profile. Moreover, eight nevi were located at the equator, five nevi were located in the posterior pole (peripapillary in one sample), and one nevus shifted from the equator to the periphery. On SD-OCT, the maximum measurable dimension was 9 mm. The lesions in the posterior pole were easier to evaluate, and image acquisition of lesions located more peripherally was possible depending on patient cooperation. The accurate assessment of height was difficult. Baseline dimensions on 10- and 20-MHz US were larger than those determined via OCT. No significant differences in height were observed between US and SD-OCT. All parameters were statistically similar between 10- and 20-MHz US measurements. CONCLUSIONS:: No significant difference in the AP and T diameters was observed between 10- and 20-MHz US measurements; however, these measurements (AP and T) were significantly higher than those obtained using OCT. No significant differences in height were observed among the techniques adopted.

Comparisons of choroidal nevus measurements obtained using 10- and 20-MHz ultrasound and spectral domain optical coherence tomography / Comparação entre a medida de nevus de coroide obtida com 10-MHz e 20-MHz e tomografia de coerência óptica de domínio espectral

ABSTRACT Purpose: To compare measurements of lesions clinically diagnosed as choroidal nevi using spectral domain optical coherence tomography (SD-OCT) and 10- and 20-MHz ultrasound (US). Methods: This prospective study, which was conducted between May 2011 and December 2011, evaluated eyes diagnosed with choroidal nevus via photographic documentation using 10- or 20-MHz A- and B-mode US (experienced examiner using both the transpalpebral technique and direct contact) or SD-OCT in the enhanced depth imaging mode (performed by a different examiner blinded to the US results). Anteroposterior (AP) and transverse (T) US sections corresponded to sections adjusted perpendicularly on SD-OCT. Results: We evaluated 14 eyes from 12 patients (six males, mean patient age= 64.5 years) diagnosed with choroidal nevus. The choroidal nevi of all samples had a melanocytic profile. Moreover, eight nevi were located at the equator, five nevi were located in the posterior pole (peripapillary in one sample), and one nevus shifted from the equator to the periphery. On SD-OCT, the maximum measurable dimension was 9 mm. The lesions in the posterior pole were easier to evaluate, and image acquisition of lesions located more peripherally was possible depending on patient cooperation. The accurate assessment of height was difficult. Baseline dimensions on 10- and 20-MHz US were larger than those determined via OCT. No significant differences in height were observed between US and SD-OCT. All parameters were statistically similar between 10- and 20-MHz US measurements. Conclusions: No significant difference in the AP and T diameters was observed between 10- and 20-MHz US measurements; however, these measurements (AP and T) were significantly higher than those obtained using OCT. No significant differences in height were observed among the techniques adopted.

RESUMO Objetivo: Comparar as medidas obtidas de lesões diagnosticadas clinicamente como nevus de coroide através da tomografia de coerência óptica de domínio espectral (Spectralis, Heidelberg Engineering, Inc.), ultrassonografia com 10 MHz e de 20 MHz. Métodos: Estudo prospectivo realizado entre maio e dezembro de 2011, avaliou olhos com diagnóstico de nevus de coroide, utilizando documentação fotográfica, ultrassonografia com transdutor 10-MHz e 20-MHz A- e B-mode e SD-OCT em modo de EDI, por um examinador diferente para cada técnica. Os cortes realizados perpendiculares entre si, correspondentes ao corte ântero-posterior e latero-lateral à ultrassonografia. Resultados: Foram avaliados 14 olhos de 12 pacientes (6 do sexo masculino), com média de idade média de 64,5 anos. Todos os nevus tinham um perfil melanocítico. Observou-se 8 nevus no equador, 5 no polo posterior (peripapilar em uma amostra), e 1 deslocado a partir do equador para a periferia. Em SD-OCT, a dimensão máxima mensurável foi de 9 mm. As lesões no polo posterior eram mais fáceis de avaliar e aquisição de imagens de lesões mais periféricas era possível, dependendo da colaboração do paciente. A avaliação precisa da altura era difícil. As dimensões usando transdutor 10-MHz e 20-MHz US foram maiores que as encontradas pelo SD-OCT. Não foram observadas diferenças significativas na altura entre métodos SD-OCT e US. Todas as medidas foram estatisticamente semelhantes entre 20-MHz e 10-MHz. Conclusão: Para o parâmetro AP e T não foi detectada diferença entre as medidas utilizando US de 10-MHz e de 20-MHz. Porém estas medidas se mostraram significativamente maiores em relação à medida obtida com OCT. Para a altura, não foram detectadas diferenças estatística em relação à técnica utilizada, US 10-MHz e 20-MHz e SD-OCT.

A study of the vitreoretinal interface in patients with age-related macular degeneration.

PURPOSE: To assess whether hyaloid adhesion is more prevalent in patients with age-related macular degeneration (AMD) than in control patients and to evaluate whether it is more prevalent in exudative AMD than in non-exudative AMD. METHODS: This was a cross-sectional, controlled analytical study. Patients from the Ophthalmology Department of the Public Service Hospital of the State of São Paulo were included if they were diagnosed with AMD that was confirmed by fundus biomicroscopy and fluorescein angiography. Patients were divided into three groups: patients without a vitreoretinal disease (controls), patients with exudative AMD, and patients with non-exudative AMD. For the optimal study of the vitreoretinal interface, all patients were subjected to spectral-domain optical coherence tomography (SD-OCT; Cirrus HD-OCT, version 4000; Carl Zeiss Meditec) and ultrasonography (UltraScan®, Alcon). Results with p values of ≤0.05 were considered statistically significant. RESULTS: We assessed 75 eyes of 23 patients with AMD (14 women and nine men) and 15 the control patients (11 women and four men). In total, 33 eyes had AMD that was consistent with the inclusion criteria, of which 11 had the non-exudative form (non-atrophic) and 22 had the exudative form (11 active and 11 disciform scars). Adherence was observed in eight eyes in the control group (26.67%), in seven eyes with exudative AMD (31.82%), and in five eyes with non-exudative AMD (45.45%). CONCLUSION: Patients with exudative and non-exudative forms of AMD did not present with higher vitreoretinal adhesion than control patients as assessed by SD-OCT and ultrasound. Moreover, patients with exudative AMD (neovascular membrane and disciform scar) did not reveal a higher adherence than those with non-exudative AMD when evaluated by the same methods.

A study of the vitreoretinal interface in patients with age-related macular degeneration / Estudo da interface vitreorretiniana em pacientes com degeneração macular relacionada à idade

ABSTRACT Purpose: To assess whether hyaloid adhesion is more prevalent in patients with age-related macular degeneration (AMD) than in control patients and to evaluate whether it is more prevalent in exudative AMD than in non-exudative AMD. Methods: This was a cross-sectional, controlled analytical study. Patients from the Ophthalmology Department of the Public Service Hospital of the State of São Paulo were included if they were diagnosed with AMD that was confirmed by fundus biomicroscopy and fluorescein angiography. Patients were divided into three groups: patients without a vitreoretinal disease (controls), patients with exudative AMD, and patients with non-exudative AMD. For the optimal study of the vitreoretinal interface, all patients were subjected to spectral-domain optical coherence tomography (SD-OCT; Cirrus HD-OCT, version 4000; Carl Zeiss Meditec) and ultrasonography (UltraScan®, Alcon). Results with p values of ≤0.05 were considered statistically significant. Results: We assessed 75 eyes of 23 patients with AMD (14 women and nine men) and 15 the control patients (11 women and four men). In total, 33 eyes had AMD that was consistent with the inclusion criteria, of which 11 had the non-exudative form (non-atrophic) and 22 had the exudative form (11 active and 11 disciform scars). Adherence was observed in eight eyes in the control group (26.67%), in seven eyes with exudative AMD (31.82%), and in five eyes with non-exudative AMD (45.45%). Conclusion: Patients with exudative and non-exudative forms of AMD did not present with higher vitreoretinal adhesion than control patients as assessed by SD-OCT and ultrasound. Moreover, patients with exudative AMD (neovascular membrane and disciform scar) did not reveal a higher adherence than those with non-exudative AMD when evaluated by the same methods.

RESUMO Objetivo: Avaliar se a adesão hialoidea é mais prevalente em pacientes com degeneração macular relacionada a idade (DMRI) (exsudativa e não exsudativa) comparado ao grupo controle e avaliar se a prevalência é maior na forma exsudativa comparada a forma não exsudativa. Métodos: Trata-se de um estudo transversal, analítico, de grupo controle, com os pacientes atendidos no Departamento de Retina do Serviço de Oftalmologia do Hospital do Servidor Público Estadual de São Paulo (HSPE), que tiveram o diagnóstico de DMRI confirmado após a biomicroscopia de fundo e angiofluoresceinografia. Os pacientes foram divididos em três grupos, um composto por pacientes sem doenças vitreorretinianas (30 olhos), outro pacientes com DMRI exsudativa (22 olhos) e o terceiro grupo por pacientes com DMRI não exsudativa (11 olhos). Para melhor estudo da interface vitreorretiniana, todos os pacientes foram submetidos aos exames de SD-TCO (Cirrus HD-TCO, versão 4000; Carl Zeeis Meditec) e ultrassonografia (UltraScan®, Alcon). Foram considerados significativos os resultados com valor de p≤0,05. Resultados: Foram avaliados 75 olhos de 23 pacientes com DMRI e 15 no grupo controle, sendo que apenas 33 olhos que apresentavam DMRI obedeciam aos critérios de inclusão, sendo 11 pertencentes à forma seca (nenhuma forma atrófica) e 22 à forma exsudativa (11 de forma ativa e 11 disciforme). A adesão foi encontrada em oito olhos no grupo controle (26,67%), em sete olhos com DMRI exsudativa (31,82%) e em cinco olhos no grupo DMRI não exsudativa (45,45%). Conclusão: Neste estudo, pacientes com DMRI (formas exsudativa e não exsudativa) não apresentaram maior adesão vitreorretiniana quando comparados ao grupo controle, ao serem avaliados através SD-TCO (Cirrus HD-TCO, versão 4000; Carl Zeeis Meditec) e ultrassonografia (UltraScan®, Alcon). Neste estudo, pacientes com DMRI exsudativa (ativa e disciforme) não apresentaram maior adesão quando comparados à forma seca, ao serem avaliados pelos mesmos métodos.