Comparative Study of Clinical, Ultrasonographic, Conventional Imaging, and Ultra-Wide-Field Fundus for Measurements of the Longest Basal Diameter of Choroidal Tumors.

BACKGROUND AND OBJECTIVE: To compare the maximum basal diameter of choroidal tumors measured by clinical estimation and different imaging methods in intraocular tumors for therapeutic planning.

PATIENTS AND METHODS: Retrospective, observational study reviewing the measurements of the longest basal diameter of choroidal tumors using the clinical estimation based on the indirect ophthalmoscopy, ophthalmic ultrasonography, 50° fundus imaging, ultra-wide-field imaging color composite, red laser, and green laser.

RESULTS: The study included measurements of 74 tumors in 74 eyes. Correlation analysis between imaging measurements and clinical estimates led to following results: ultra-wide-field imaging measurements were 2.7% to 7.1% smaller than estimated clinical measurements by indirect ophthalmoscopy; followed by ultrasound, with 10.9% smaller measurements; and 50° fundus imaging, measuring 25.8% smaller than clinical estimates. When evaluating the precision of tumor measurements, ultrasound resulted in the highest precision, with a standard error of 1.6 mm compared to clinical estimates, followed by other imaging techniques with standard errors ranging from 2.4 mm to 3.0 mm. Determination of tumor margins with the ultrasound technique was better defined when subretinal fluid was present, or when the height of the tumor was greater than 3 mm.

CONCLUSION: The authors' results suggest that measurements of the longest basal diameter of choroidal tumors can be accurately performed with ultrasound and ultra-wide-field color composite or red laser images. In the presence of subretinal fluid or tumor height above 3 mm, ultrasound can better delineate tumor margins. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:459-464.].