PDF(Pubmed)
Abstract：
In this study, we aimed to identify the features of indeterminate choroidal melanocytic lesions visualized on optical coherence tomography angiography (OCTA) and to identify the predictors of growth. We retrospectively evaluated 86 patients with indeterminate lesions treated at our centre from 2016 to 2021. Clinical management involved active surveillance followed by brachytherapy if growth was detected. The lesions were classified into two groups according to whether they grew (small melanomas) or remained stable (choroidal nevi). Growth was detected in 19 (22.1%) lesions. All patients underwent OCTA at baseline. These images were compared to identify the possible predictors of growth. Significant between-group differences were observed in thickness (p = 0.00), greatest basal diameter (p = 0.00), number of risk factors (p = 0.00), symptoms (p = 0.001; relative risk [RR]: 4.3), orange pigment (p = 0.00; RR: 6.02), and ultrasonographic hollowness (Kappa sign); p = 0.000; RR: 5.3). The melanomas had significantly more vessels with a diameter ≥ 76.3 µm (p = 0.02; RR: 2.46). The time to growth in these lesions was significantly shorter (p = 0.05) than in lesions with smaller vessels. These findings show that vessel diameter quantified by OCTA can help differentiate between choroidal nevi and small melanomas, when considered together with clinical risk factors.
摘要：
在这项研究中,我们旨在确定光学相干断层扫描血管造影(OCTA)显示的不确定脉络膜黑色素细胞病变的特征,并确定生长的预测因素.我们回顾性评估了2016年至2021年在我们中心治疗的86例不确定病变的患者。临床管理包括主动监测，如果检测到生长，则进行近距离放射治疗。根据病变是否生长（小黑色素瘤）或保持稳定（脉络膜痣）将病变分为两组。在19个（22.1％）病变中检测到生长。所有患者在基线时接受OCTA。比较这些图像以确定可能的生长预测因子。在厚度方面观察到显著的组间差异(p=0.00),最大基径(p=0.00)，风险因素数(p=0.00)，症状（p=0.001；相对风险[RR]：4.3），橙色颜料（p=0.00；RR：6.02），超声空心度（Kappa符号）；p=0.000；RR：5.3）。黑色素瘤的血管明显更多，直径≥76.3µm（p=0.02；RR：2.46）。这些病变的生长时间明显短于血管较小的病变（p=0.05）。这些发现表明，OCTA量化的血管直径可以帮助区分脉络膜痣和小黑素瘤。当与临床危险因素一起考虑时。
