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  • Title: Choroidal melanocytosis evaluation with enhanced depth imaging optical coherence tomography.
    Author: Pellegrini M, Shields CL, Arepalli S, Shields JA.
    Journal: Ophthalmology; 2014 Jan; 121(1):257-261. PubMed ID: 24139152.
    Abstract:
    OBJECTIVE: To assess eyes with unilateral choroidal melanocytosis using enhanced depth imaging (EDI) optical coherence tomography (OCT). DESIGN: Retrospective, observational case series. PARTICIPANTS: Fifteen patients with unilateral choroidal melanocytosis. METHODS: Each patient was evaluated with EDI-OCT, and comparison was made of involved versus uninvolved foveal retinal and choroidal layers. MAIN OUTCOME MEASURES: Enhanced depth imaging OCT features of choroidal melanocytosis. RESULTS: The mean patient age was 28 years (median, 23 years; range, 5-76 years). There were 9 male and 6 female patients. Best-corrected visual acuity ranged from 20/20 to 20/30. All patients had subfoveal involvement with choroidal melanocytosis. Associated features included dermal (n = 6), scleral (n = 9), iris (n = 3), and palate (n = 1) melanocytosis. Spectral domain EDI-OCT revealed normal inner retina (n = 15) and normal outer retina (n = 14). The only retinal abnormality was a defect in both the myoid zone and the ellipsoid junction (n = 1). The affected choroid showed smooth anterior contour (n = 15) and thinned or compressed choriocapillaris (n = 2), thinned (n = 3) or thickened (n = 3) medium vessels, and thinned large vessels (n = 2). The subfoveal choroid was a mean 23% thicker in the involved eye, with a mean thickness of 326.4 μm (median, 326 μm; range, 120-459 μm) compared with 264.4 μm (median, 260 μm; range, 94-462 μm) in the uninvolved eye (P = 0.15). The choroidal perivascular interstitial tissue was 51% thicker in the study eye, enwrapping and silhouetting the medium and large vessels (P = 0.01). The ratio between the perivascular stromal tissue and the subfoveal choroidal thickness was 66% in the study eye and 54% in the normal eye (P = 0.0001). Deep partial (n = 5) or complete (n = 2) tissue shadowing was noted. CONCLUSIONS: Enhanced depth imaging OCT revealed that choroidal melanocytosis shows increased subfoveal choroidal thickness with an apparent increase in the choroidal perivascular stromal tissue and minimal effect on the overlying retina.
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