ULTRASOUND BIOMICROSCOPIC IMAGING OF THE ANTERIOR ASPECT OF PERIPHERAL CHOROIDAL MELANOMAS

PURPOSE: To correlate ultrasound biomicroscopic features of the anteri or aspect of peripheral choroidal melanoma with respect to histopathol ogy. METHODS: We examined 17 eyes of 17 patients who had clinically di agnosed peripheral choroidal melanomas that approached the ora serrata or extended into the ciliary body and who had been assessed with ultr asound biomicroscopy before enucleation. Comparisons were made between anterior tumor margins imaged by ultrasound biomicroscopy and histopa thologic specimens. Anatomic features noted on ultrasound biomicroscop y before enucleation were correlated with enucleation specimens, inclu ding supraciliary effusion, rotation of the ciliary body, angle involv ement, and internal reflectivity patterns, Anterior tumor margin posit ion was determined with reference to the scleral spur. RESULTS: Mean d istances from the anterior tumor margin to the scleral spur were 1.47 mm on ultrasound biomicroscopy and 1.65 mm on pathologic examination. This difference was not statistically significant (P = .325). Tumor fe atures evident on ultrasound biomicroscopy were also seen on pathologi c examination: supraciliary choroidal effusions in seven of seven, cil iary body rotation in seven of eight, and angle involvement in seven o f eight. All tumors were mixed cell melanomas, and 12 of 17 (70%) demo nstrated homogeneous ultrasound biomicroscopic internal reflectivity. Irregular internal reflectivity was seen in five of 17 tumors (29%) an d was related to prominent internal vascularity on pathology in three of five. CONCLUSIONS: Ultrasound biomicroscopy is an accurate imaging technique for the in vivo assessment of anterior tumor margins of peri pheral choroidal melanomas and can provide detailed imaging of the tum or's interface with the ciliary body.