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CORRELATION OF FUNDUS AUTOFLUORESCENCE WITH FLUORESCEIN AND INDOCYANINE GREEN ANGIOGRAPHY IN CHOROIDAL MELANOCYTIC LESIONS

2008; Lippincott Williams & Wilkins; Volume: 28; Issue: 9 Linguagem: Inglês

10.1097/iae.0b013e31817d5cdc

1539-2864

Kaan Gündüz, José S. Pulido, Jose E. Pulido, Thomas P. Link,

Cutaneous Melanoma Detection and Management

In Brief Purpose: To correlate fundus autofluorescence (FAF) patterns with fluorescein/indocyanine green angiographic (FA/ICGA) features in choroidal melanocytic lesions. Methods: Retrospective chart review of 30 consecutive patients with choroidal nevi and melanoma who underwent FAF photography and FA/ICGA. The FAF pattern was classified as patchy or diffuse. The FA images were evaluated at the arterial, early venous, late venous, midphase, and late phases. The ICGA images were evaluated at the early and midlate phase. The fluorescence within the tumor was classified as hyperfluorescent, pinpoint hyperfluorescent, isofluorescent, or hypofluorescent with respect to the surrounding retina or choroid. Statistical analysis was performed using two sample t test for continuous data. For categorical or ordinal data, Pearson chi-square or Fisher's exact test was used depending on the sample size being studied. Results: Nineteen of 30 tumors (63.3%) were choroidal melanoma and 11 (36.7%) were choroidal nevus. Thirteen choroidal melanomas had a diffuse FAF pattern. Six choroidal melanomas and 11 choroidal nevi had a patchy FAF pattern. The diffuse FAF pattern was significantly associated with the clinical diagnosis of choroidal melanoma versus choroidal nevus (P = 0.00001), increased tumor thickness (P = 0.00001), and increased tumor base diameter (P = 0.001), partially pigmented or amelanotic versus pigmented lesion color (P = 0.006), early venous hyperfluorescence on FA (P = 0.015), and late hyperfluorescence on FA (P = 0.018). Conclusion: Diffuse FAF is more often associated with larger choroidal melanomas as well as early venous and late hyperfluorescence on FA angiography. Choroidal melanomas can have a patchy or diffuse fundus autofluorescence (FAF) pattern. Diffuse FAF is more often associated with larger choroidal melanomas as well as early venous and late hyperfluorescence on fluorescein angiography.