Clinical Applications of Optical Coherence Tomography in Intraocular Tumors

  • Carol L. Shields
  • Miguel A. Materin
  • Jerry A. Shields

There are several tumors that can occur in the posterior segment of the eye.1,2 They are generally classified based on the main tissue involved such as the choroid, retinal pigment epithelium (RPE), or retina. The spectrum of tumors in each tissue varies. For example, tumors in the choroid include the melanocytic nevus, melanoma, metastasis, cavernous hemangioma, and other less common tumors such as lymphoma, neurilemoma, leiomyoma, and osteoma.1,2 Lesions of the RPE include congenital hypertrophy, congenital simple hamartoma, combined hamartoma, reactive hyperplasia, adenoma, and adenocarcinoma. Those affecting the retina include capillary hemangioma, cavernous hemangioma, racemose hemangioma, vasoproliferative tumor, astrocytic hamartoma, and retinoblastoma. The differentiation of these tumors by experienced clinicians is made primarily by indirect ophthalmoscopy. Ancillary testing with intravenous fluorescein angiography, indocyanine green angiography, ultrasonography, optical coherence tomography (OCT), color Doppler testing, magnetic resonance imaging, computed tomography, and fine-needle aspiration biopsy can assist in confirming the diagnosis.1,2 This chapter presents the OCT findings of selected intraocular tumors.


Optical Coherence Tomography Retinal Pigment Epithelium Cavernous Hemangioma Subretinal Fluid Choroidal Melanoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Shields JA, Shields CL. Intraocular Tumors: A Text and Atlas. Philadelphia: WB Saunders, 1992.Google Scholar
  2. 2.
    Shields JA, Shields CL. Atlas of Intraocular Tumors. Philadelphia: Lippincott Williams & Wilkins, 1999.Google Scholar
  3. 3.
    Sumich P, Mitchell P, Wang JJ. Choroidal nevi in a white population: the Blue Mountains Study. Arch Ophthalmol 1998;116:645–650.PubMedGoogle Scholar
  4. 4.
    Shields CL, Shields JA, Kiratli H, Cater JR, De Potter P. Risk factors for growth and metastasis of small choroidal melanocytic lesions. Ophthalmology 1995;102:1351–1361.PubMedGoogle Scholar
  5. 5.
    Shields CL, Cater JC, Shields JA, Singh AD, Santos MCM, Carvalho C. Combination of clinical factors predictive of growth of small choroidal melanocytic tumors. Arch Ophthalmol 2000;118:360–364.PubMedGoogle Scholar
  6. 6.
    Shields CL, Demirci H, Materin MA, Marr BP, Mashayekhi A, Shields JA. Clinical factors in the identification of small choroidal melanoma. Can J Ophthalmol 2004;39:351–357.PubMedGoogle Scholar
  7. 7.
    Shields CL, Mashayekhi A, Materin MA, Luo CK, Marr BP, Demirci H, Shields JA. Optical coherence tomography of choroidal nevus in 120 patients. Retina 2005;25:243–252.PubMedCrossRefGoogle Scholar
  8. 8.
    Espinoza G, Rosenblatt B, Harbour JW. Optical coherence tomography in the evaluation of retinal changes associated with suspicious choroidal melanocytic tumors. Am J Ophthalmol 2004;137:90–95.PubMedCrossRefGoogle Scholar
  9. 9.
    Shields JA, Shields CL, Donoso LA. Management of posterior uveal melanomas. Surv Ophthalmol 1991;36:161–195.PubMedCrossRefGoogle Scholar
  10. 10.
    Shields CL, Shields JA. Recent developments in the management of choroidal melanoma. Curr Opin Ophthalmol 2004;15:244–251.PubMedCrossRefGoogle Scholar
  11. 11.
    Shields CL, Shields JA, DePotter P, Cater J, Tardio D, Barrett J. Diffuse choroidal melanoma: clinical features predictive of metastasis. Arch Ophthalmol 1996;114:956–963.PubMedGoogle Scholar
  12. 12.
    Shields CL, Demirci H, Dai V, Marr BP, Mashayekhi A, Materin MA, Manquez ME, Shields JA. Intravitreal triamcinolone acetonide for radiation maculopathy after plaque radiotherapy for choroidal melanoma. Retina 2005;25:868–874.PubMedCrossRefGoogle Scholar
  13. 13.
    Shields CL, Shields JA, Gross N, Schwartz G, Lally S. Survey of 520 uveal metastases. Ophthalmology 1997;104:1265–1276.PubMedGoogle Scholar
  14. 14.
    Manquez ME, Shields CL, Karatza EC, Shields JA. Regression of choroidal metastases from breast carcinoma using aromatase inhibitors. Br J Ophthalmol 2005;89:776–777.PubMedCrossRefGoogle Scholar
  15. 15.
    Shields CL, Honavar SG, Shields JA, Cater J, Demirci H. Circumscribed choroidal hemangioma. Clinical manifestations and factors predictive of visual outcome in 200 consecutive cases. Ophthalmology 2001;108:2237–2248.PubMedCrossRefGoogle Scholar
  16. 16.
    Mashayekhi A, Shields CL. Circumscribed choroidal hemangioma. Curr Opin Ophthalmol 2003;14:142–149.PubMedCrossRefGoogle Scholar
  17. 17.
    Shields JA, Shields CL, Materin MA, Marr BP, Demirci H, Mashayekhi A. Changing concepts in management of circumscribed choroidal hemangioma. The 2003 J. Howard Stokes Lecture, part 1. Ophthalmic Surg Lasers Imaging 2004;35:383–393.PubMedGoogle Scholar
  18. 18.
    Materin MA, Shields CL, Marr BP, Shields JA. Restoration of anatomic fovea following photodynamic therapy (PDT) for circumscribed choroidal hemangioma. Submitted for publication.Google Scholar
  19. 19.
    Shields CL, Materin MA, Marr BP, Mashayekhi A, Shields JA. Resolution of advanced cystoid macular edema following photodynamic therapy of choroidal hemangioma. Ophthalmic Surg Lasers Imaging 2005;36:237–239.PubMedGoogle Scholar
  20. 20.
    Gass JD, Guerry RK, Jack RL, Harris G. Choroidal osteoma. Arch Ophthalmol 1978;96:428–435.PubMedGoogle Scholar
  21. 21.
    Shields CL, Shields JA, Augsburger JJ. Choroidal osteoma. Surv Ophthalmol 1988;33:17–27.PubMedCrossRefGoogle Scholar
  22. 22.
    Aylward GW, Chang TS, Pautler SE, Gass JD. A long-term follow-up of choroidal osteoma. Arch Ophthalmol 1998;116:1337–1341.PubMedGoogle Scholar
  23. 23.
    Shields CL, Sun H, Demirci H, Shields JA. Factors predictive of tumor growth, tumor decalcification, choroidal neovascularization, and visual outcome in 74 eyes with choroidal osteoma. Arch Ophthalmol 2005;123:1658–1666.PubMedCrossRefGoogle Scholar
  24. 24.
    Ide T, Ohguro N, Hayashi A, et al. Optical coherence tomography patterns of choroidal osteoma. Am J Ophthalmol 2000;130:131–134.PubMedCrossRefGoogle Scholar
  25. 25.
    Fukasawa A, Iijima H. Optical coherence tomography of choroidal osteoma. Am J Ophthalmol 2002;133:0419–421.CrossRefGoogle Scholar
  26. 26.
    Shields JA, Shields CL, Gunduz K, Eagle RC Jr. Neoplasms of the retinal pigment epithelium. The 1998 Albert Ruedemann Sr. Memorial Lecture. Part 2. Arch Ophthalmol 1999;117:601–608.PubMedGoogle Scholar
  27. 27.
    Shields CL, Mashayekhi A, Ho T, Cater J, Shields JA. Solitary congenital hypertrophy of the retinal pigment epithelium: clinical features and frequency of enlargement in 330 patients. Ophthalmology 2003;110:1968–1976.PubMedCrossRefGoogle Scholar
  28. 28.
    Shields JA, Shields CL, Singh AD. Acquired tumors arising from congenital hypertrophy of the retinal pigment epithelium. Arch Ophthalmol 2000;118:637–641.PubMedGoogle Scholar
  29. 29.
    Shields CL, Shields JA, Marr BP, Sperber DE, Gass JDM. Congenital simple hamartoma of the retinal pigment epithelium. A study of five cases. Ophthalmology 2003;110: 1005–1011.PubMedCrossRefGoogle Scholar
  30. 30.
    Shields CL, Materin MA, Karatza E, Shields JA. Optical coherence tomography (OCT) of congenital simple hamartoma of the retinal pigment epithelium. Retina 2004;24: 327–328.PubMedCrossRefGoogle Scholar
  31. 31.
    Schachat AP, Shields JA, Fine SL, et al. The Macula Society Research Committee. Combined hamartomas of the retina and retinal pigment epithelium. Ophthalmology 1984;91: 1609–1614.PubMedGoogle Scholar
  32. 32.
    Ting TD, McCuen BWII, Fekrat S. Combined hamartoma of the retina and retinal pigment epithelium: optical coherence tomography. Retina 2002;22:98–101.PubMedCrossRefGoogle Scholar
  33. 33.
    Shields CL, Mashayekhi A, Dai VV, Materin MA, Shields JA. Optical coherence tomography findings of combined hamartoma of the retina and retinal pigment epithelium in 11 patients. Arch Ophthalmol 2005;123:1746–1750.PubMedCrossRefGoogle Scholar
  34. 34.
    Shields CL, Mashayekhi A, Luo CK, Materin MA, Shields JA. Optical coherence tomography in children: analysis of 44 eyes with intraocular tumors and simulating conditions. J Pediatr Ophthalmol Strabismus 2004;41:338–344.PubMedGoogle Scholar
  35. 35.
    Stallman JB. Visual improvement after pars plana vitrectomy and membrane peeling for vitreoretinal traction associated with combined hamartoma of the retina and retinal pigment epithelium. Retina 2002;22:101–104.PubMedCrossRefGoogle Scholar
  36. 36.
    Shields JA, Shields CL. Tumors of the retina and optic disc. In: Regillo CD, Brown GC, Flynn HW Jr eds. Vitreoretinal Disease. The Essentials. New York: Thieme, 1999: 439–454.Google Scholar
  37. 37.
    Shields CL, Shields JA. Phakomatoses. In: Regillo CD, Brown GC, Flynn HW Jr, eds. Vitreoretinal Disease. The Essentials. New York: Thieme, 1999:377–390.Google Scholar
  38. 38.
    Singh AD, Shields CL, Shields JA. Major review: Von Hippel-Lindau disease. Surv Ophthalmol 2001;46:117–142.PubMedCrossRefGoogle Scholar
  39. 39.
    Materin MA, Shields CL, Marr BP, Demirci H, Shields JA. Retinal racemose hemangioma. Retina 2005;25:936–937.PubMedCrossRefGoogle Scholar
  40. 40.
    Shah GK, Shields JA, Lanning R. Branch retinal vein obstruction secondary to retinal arteriovenous communication. Am J Ophthalmol 1998;126:446–448.PubMedCrossRefGoogle Scholar
  41. 41.
    Shields CL, Shields JA. Recent developments in the management of retinoblastoma. J Pediatr Ophthalmol Strabism 1999;36:8–18.Google Scholar
  42. 42.
    Shields CL, Meadows AT, Leahey AM, Shields JA. Continuing challenges in the management of retinoblastoma with chemotherapy. Retina 2004;24:849–862.PubMedCrossRefGoogle Scholar
  43. 43.
    Mashayekhi A, Shields CL, Eagle RC Jr, Shields JA. Cavitary changes in retinoblastoma: relationship to chemoresistance. Ophthalmology 2005;112:1145–1150.PubMedCrossRefGoogle Scholar
  44. 44.
    Shields CL, Materin MA, Shields JA. Restoration of foveal anatomy and function following chemoreduction for bilateral advanced retinoblastoma with total retinal detachment. Arch Ophthalmol 2005;123:1610–1612.PubMedCrossRefGoogle Scholar
  45. 45.
    Shields JA, Demirci H, Mashayekhi A, Shields CL. Melanocytoma of the optic disc in 115 cases. The 2004 Samuel Johnson Memorial Lecture. Ophthalmology 2004;111: 1739–1746.PubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Carol L. Shields
    • 1
  • Miguel A. Materin
    • 1
  • Jerry A. Shields
    • 1
  1. 1.Ocular Oncology Service, Wills Eye HospitalThomas Jefferson UniversityPhiladelphia

Personalised recommendations