Optical coherence tomography and fundus autofluorescence features in choroidal and retinal tumors

The aim of the study was todescribe the clinical features, optical coherence tomography (OCT) and fundus autofluorescence (FAF) imaging in patients with choroidal and retinal tumors. Ninety eyes of 89 patients with treatment-naive macular, midperipheral, and juxtapapillary choroidal and retinal tumors were retrospectively included in the study. All patients underwent a complete ophthalmic examination, B-mode ultrasonography, OCT, and FAF imaging. OCT and FAF images taken at the time of diagnosis were reviewed retrospectively. Choroidal nevus (CN), choroidal malignant melanoma (CMM), optic disc melanocytoma (ODM), circumscribed choroidal hemangioma (CCH), and choroidal osteoma (CO) displayed dome-shaped contour on OCT, while choroidal metastases (CM) showed a lumpy bumpy contour. CN had preserved choriocapillaris. Choroidal compression was observed in all choroidal tumors except CCH which showed vascular expansion. CMM was the most common lesion displaying overlying lipofuscin. Intraretinal fluid was seen mostly in CCM and CCH. Subretinal fluid (SRF) was usually observed in CM, CMM, and CCH. Drusen and pigment epithelial detachment (PED) were noted in CN. While the pattern of hyperautofluorescence (hyper-AF) was most marked in CMM, other tumors including CCH and CM occasionally showed similar FAF appearance. Comparing CN and CMM; CN displayed more drusen and PED (p = 0.024 and p = 0.037 respectively) and CMM showed more SRF, intraretinal fluid, and shaggy photoreceptor (p = 0.040, p < 0.001, and p < 0.001 respectively). CN displayed more hypo-AF and iso-AF (p < 0.001) while CMM showed significantly more diffuse and patchy hyper-AF (p < 0.001). Characteristic findings in OCT and FAF guide clinicians in the differential diagnosis of choroidal and retinal tumors and allow for earlier detection and improved treatment outcomes.