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. 2023 Apr;37(5):1014-1018.
doi: 10.1038/s41433-022-02185-1. Epub 2022 Jul 25.

Evaluation of optical coherence tomography (OCT) changes following transretinal tumour biopsy for choroidal melanoma

Shah Haider  1 , Taktak Azam  2   3 , Gatchalian Leandro  2 , Heimann Heinrich  2 , Hussain Rumana  2
Affiliations

Evaluation of optical coherence tomography (OCT) changes following transretinal tumour biopsy for choroidal melanoma

Shah Haider et al. Eye (Lond). 2023 Apr.

Abstract

Aim: This study uses OCT imaging to examine morphological changes at the chorioretinal interface of the choroidal melanoma biopsy site over time.

Setting: Liverpool Ocular Oncology Centre (LOOC), St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.

Methodology: Retrospective analysis of all patients who underwent 25G vitrector-assisted transretinal biopsy for choroidal melanoma between 1st Jan 2017 and 31st Dec 2019. The biopsy procedure does not involve full vitrectomy, treatment of the retinal hole or tamponade. Patients routinely undergo OCT imaging over the tumour site at each follow up. Cases required a minimum of a baseline OCT and two consecutive post-operative OCT scans of adequate quality, overlying the biopsy site. All images were reviewed and graded by an ophthalmic specialist.

Results: Fifty-one patients met the criteria for inclusion. OCT analysis identified 2 characteristic morphologies following transretinal biopsy -a choroidal plugging of biopsy site (47.0%), or a flat retinal hole (53.0%). Choroidal plugging morphologies tend to remain unchanged over time, whereas flat holes demonstrate greater variability and would more commonly seal over with atrophic retina (Fisher Exact Value = <0.01). 60.8% demonstrated vitreous plugging of the biopsy site.

Conclusion: OCT analysis has identified key morphological changes following transretinal choroidal melanoma biopsy. The morphologies identified may provide dynamic protective effects against vitreous flow into the subretinal space, accounting for low rates of retinal detachment despite the presence of an untreated iatrogenic retinal hole following transretinal biopsy.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. OCT of Vitreous Adherance.
Vitreous adherence to biopsy site in two separate cases, as marked by arrowheads.
Fig. 2
Fig. 2. OCT of Tumour Plug Morphology.
OCT series demonstrating tumour plug stability over 2 year period.
Fig. 3
Fig. 3. OCT of Tumour Plug Morphology.
Progression of Tumour Plug extending into vitreous as marked by arrowheads.
Fig. 4
Fig. 4. OCT Series of Open, Retinal Hole Morphology.
a OCT series demonstrating progression in an ‘open, retinal hole’ morphology at the biopsy site. Note the eventual choroidal atrophy, as highlighted by the arrowhead. b OCT series demonstrating progression in an ‘open, retinal hole’ morphology with development of an overlying glial membrane, as highlighted by the arrowhead.
See this image and copyright information in PMC

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