Anterior segment imaging for iris melanocytic tumors

To determine the role of anterior segment optical coherence tomography (AS-OCT) and other anterior segment imaging techniques (Pentacam, slit-lamp optical coherence tomography [SL-OCT]) for analysis of iris melanocytic tumors and to compare results with clinical features and ultrasound biomicroscopy (UBM).

Between 2006 and 2009, 61 patients with melanocytic iris tumors were examined using different anterior segment imaging techniques: Pentacam, SL-OCT, AS-OCT, and UBM (50 MHz). Pentacam was performed in 17 patients, SL-OCT in 12, AS-OCT in 46, and UBM in 49.

The Pentacam images identified the tumor in 3 of 17 patients (18%), SL-OCT in 8 of 12 (67%), and AS-OCT in 44 of 46 (96%). Anterior segment optical coherence tomography results were compared with UBM in 42 patients: in 86% the results were comparable, although AS-OCT visualized a ciliary body extension of iris tumors only in 1 out of 3 cases analyzed.

Iris melanocytic tumors were located by AS-OCT in 96% of cases and results were comparable to UBM imaging, while both SL-OCT and Pentacam are less reliable for detecting and measuring anterior segment lesions. Anterior segment optical coherence tomography gives precise anterior eye segment diameters, which are useful for the brachytherapy dosage calculation module developed at the Leiden University Medical Center. Therefore, AS-OCT is a reliable, convenient, and noncontact method for detecting and measuring pure iris tumors, but UBM is superior in detecting a ciliary body extension of these tumors.