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Ultrasound Biomicroscopy With Histopathologic Correlation

Flavio A. Marigo, MD; Paul T. Finger, MD; Steven A. McCormick, MD; Raymond Iezzi, MD; K. Esaki, MD; H. Ishikawa, MD; Jeffrey M. Liebmann, MD; Robert Ritch, MD

Arch Ophthalmol. 2000;118:1515-1521.

Objective  To correlate ultrasound biomicroscopic images of iris and ciliary body melanomas with their histopathologic features.

Methods  Ultrasound biomicroscopy was performed in 3 cases of iris melanoma and in 3 cases of ciliary body melanoma. Cross-sectional ultrasound biomicroscopic images were compared with findings from clinical examination and light microscopy to evaluate associations between their histopathologic, surface, and internal ultrasound characteristics. Unique images of intrastomal and obscured posterior tumor margins were visualized by ultrasound biomicroscopy.

Results  Results of this study revealed that ultrasound biomicroscopy offers an accurate method to evaluate tumor shape, reflectivity, and local invasion. Neoplastic tissue had only medium echogenicity. Enlarged vessels were correlated to echolucent spaces in the iris stroma. Anterior tumor margins were found within the iris stroma, within the anterior chamber angle, and on the endothelial surface of the cornea. Posterior tumor extension was noted to encroach onto the lens, into the sclera, and serous peripheral retinal detachments were associated with ciliary body tumors.

Conclusion  Ultrasound biomicroscopic images correlated well with histopathologic features of anterior uveal melanomas including shape, reflectivity, and local extension.

From the Departments of Ophthalmology (Drs Marigo, Finger, McCormick, Iezzi, Esaki, Ishikawa, Liebmann, and Ritch) and Pathology and Laboratory Medicine (Dr McCormick), The New York Eye and Ear Infirmary, and Department of Ophthalmology, New York University School of Medicine, (Dr Finger) New York, NY; and the Department of Ophthalmology, New York Medical College, Valhalla (Drs Liebmann and Ritch). Drs Ishikawa, Liebmann, and Ritch have received consultant fees from Paradigm Medical, Salt Lake City, Utah.

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