Assessment of Anterior Segment Tumorswith

Ultrasound Biomicroscopy versus

Anterior Segment Optical CoherenceTomography in 200 Cases

dr. R.M. Irsan

Source:Carlos Bianciotto et al:Ophthalmology 2011;118:1297–1302

Ophthalmology DepartmentSriwijaya University Faculty of Medicine

dr. Muhammad Hoesing Hospital Palembang2011

Journal reading

AS-OCT OCT imaging anterior segment ocular

structuressuperluminescent light-emitting diode 1310

nanometers wave length 18 microns resolution & 3 to 4 mm penetration

Introduction

UBMHigh frequency ultrasound 20-50MHzIn 50 MHz mode 25 microns resolution and

5-6mm penetration

Previous study showed UBM and AS-OCT on the fields of glaucoma

Evaluation of anterior segment tumors using UBM and AS-OCT are rare

To compare UBM and AS-OCT for imaging tumors of the anterior segment of the eye

AIM

200 patient with anterior segment tumors scanned with both AS-OCT and UBM on the Oncology service, Wills Eye Institute, Philadelphia between June 2008 – March 2010

Methods

UBM OPKO instrumentation/OTI was set to 50MHz

AS-OCT Visante OCT 3.0

Methods

Demographic data included Age Gender

Tumor features Involved tissue Diagnosis Color Thickness Location shape

UBM & AS-OCT data Acoustic feature Internal tumor pattern Tumor thickness Tumor base Tumor configuration Tumor margins

Result

200 patients

Age ranging from 2 – 95 yrs

old(mean 50 yrs

old)

74 (37%) Male126 (63%)

female

Eye involvements

Iris stroma 96 eyes (48%)

IPE 44 eyes (22%)

Iris and ciliary body 32 eyes (16%)

Ciliary body 14 eyes (7%)

Conjunctiva 6 eyes (3%)

Sclera 4 eyes (2%)

Ciliary body+choroid 2 eyes (1 %)

iris+ciliary body+choroid 2 eyes (1%)

Opop[

Imaging comparisonVisibility of tumor margins

• Equal on anterior margins ( 90% vs 82%)• Favorable UBM on posterior margin (90%

vs 29%)• All tumor margins were well visualized with

UBM 95%• Tumor shadowing rarely found on UBM

(5%) but more on AS-OCT (72%)

In general, UBM was more favorable for resolution of the posterior margin of the lesion and for structures from the pigment epithelium posteriorly, whereas AS-OCT was more favorable for anterior margin and ocular structures anterior to the IPE

Overall, UBM was more favorable for complete tumor resolution in IPE cyst and iris melanoma, and both UBM and AS-OCT were equivalent for iris nevus

Discussion