In vivo optical biopsy of choroidal osteoma: a swept source optical coherence tomography-based tumor characterization.

OBJECTIVE: To study tumor characteristics of choroidal osteoma by swept source optical coherence tomography. METHODS: A retrospective case series done at tertiary referral center in northern India. All patients diagnosed with choroidal osteoma examined on swept source optical coherence tomography were included. Swept source optical coherence tomography images were analyzed for integrity of retinal layers-intraretinal layers, outer retinal layers (photoreceptor), retinal pigment epithelium, and contour abnormalities. Choroidal changes assessed were tumor attributes such as shape, depth of choroidal involvement, tumor mass reflectivity pattern, tumor vascularity, and evolutionary structural abnormalities such as deossification, focal depressions, or choroidal neovascular membrane. RESULTS: A total of 15 eyes of 11 patients were analyzed. Seven of 11 patients were females. Mean age of presentation was approximately 26 years. Tumor was large in nine cases (>7.5 mm). Deossification was seen in 12 eyes. Inner and outer retinal integrity was maintained in 7 and 2 eyes, respectively. Most common internal tumor reflectivity pattern seen was a lamellar appearance (12/15). Increased signal transmission to choroid and focal area of deep excavation was present in 11 and 4 eyes, respectively. Osteoclastic activity was noted in 12 eyes. Choroidal neovascular membrane was seen in 6 eyes. Small lesions showed lamellar pattern of tumor reflectivity with preservation of retinal pigment epithelium and overlying retina. Larger tumors were deossified with 6 irregular tumor contour, disorganization of the outer retina, increased signal transmission to choroid, and areas of osteoclastic activity. CONCLUSION: Swept source optical coherence tomography was helpful in assessing tumor attributes and predicting the different timelines in tumor evolution.

Swept-source optical coherence tomography of an optic disc melanocytoma: The importance of the hyperreflective foci.

Optic disc melanocytoma (ODM) has been considered as a benign tumor with few reports of malignant transformation. We present swept-source optical coherence tomography (SSOCT) imaging of a case of ODM. As attaining histopathology is impossible in most cases, we discuss the possibility of using SSOCT as a tool for ruling out choroidal invasion or juxtapapillary melanoma.

Combined Hamartoma of the Retina and Retinal Pigment Epithelium: An Optical Coherence Tomography-Based Reappraisal.

PURPOSE: To analyze the optical coherence tomography (OCT) characteristics of combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) involving the macula. DESIGN: Retrospective, observational case series. METHODS: setting: Single institutional. STUDY POPULATION: Fourteen consecutive patients of CHRRPE were included. OBSERVATION PROCEDURES: The authors analyzed the clinical features, color fundus photography, and swept-source or spectral-domain OCT of all the involved eyes. MAIN OUTCOME MEASURES: OCT characteristics, especially the involvement of the retinal pigment epithelium (RPE). RESULTS: A total of 16 eyes of 5 female and 9 male patients were analyzed. The mean age (± SD) was 17.9 ± 6.4 (range 10-34) years. Mean best-corrected visual acuity (± SD) in logMAR was 0.9 ± 0.5 (20/160 ± 20/60). The OCT was suggestive of a focal mass-like lesion primarily involving the inner retinal layers limited externally by the outer plexiform layer (OPL) in 15 eyes (93.7%). The OPL appeared to have a saw-tooth appearance ("intraretinal peaks") in 12 eyes (75%). The convolutions of the OPL were broader and deeper in some eyes (5 eyes, 31.2%), giving an "omega sign" (ω) appearance. The ellipsoid zone appeared intact in 13 eyes (81.2%). The RPE band appeared intact in all eyes. CONCLUSIONS: Considering the OCT features, available evidence, and embryology, we propose that the true nature of CHRRPE should be reanalyzed. In our series, CHRRPE was noted to be primarily a hamartoma arising from the inner retinal layers. A majority of cases were limited posteriorly by the OPL without any involvement of the outer retinal layers and RPE.

Ultra-wide Field Imaging and Swept Source Optical Coherence Tomography of Ocular Electrical Injury in a Child.

History of trauma in children may be obscured and physicians often rely on signs for diagnosis. The authors discuss a case of electrical injury where ocular signs led to diagnosis of the cause of macular atrophy. A high index of suspicion must always be maintained in such atypical cases, and the setting of electrical injury to the body requires meticulous ocular examination. [J Pediatr Ophthalmol Strabismus. 2016;53:e69-e71.].