"En face" OCT in Small Pigmented Choroidal Tumors

Background "En face" optical coherence tomography (OCT) is an imaging technique with optic sections parallel to the retinal pigment epithelium (RPE). This study aims to define the use of this technique in the evaluation of small pigmented choroidal tumors. Patients and Methods Investigation of 27 small pigmented choroidal tumors with "en face" OCT. Following manual segmentation, the optic sections performed with a spectral domain OCT at 30, 80 and 130 µ under the RPE were selected for morphological and statistical analysis. Results Internal tumor reflectance is variable (hyper-, iso-, or hypo-reflective), with a uniform or a bull's eye appearance. The reflectance becomes progressively lower towards the centre of the tumor. The margins of the pigmented tumors appear similar or less extensive than ophthalmoscopically. Peritumoral vascularization appears distinct from the 80 µ section downwards. Conclusions On "en face" OCT, small pigmented choroidal tumors present with a uniform or bull's eye internal reflectance, and are of variable intensity relative to the surrounding choroid. Their margins can appear more restrained than those on colour fundus photography.