Possible role of standardized echography complementing ultrasound biomicroscopy in tumors of the anterior eye segment: a study in a series of 13 patients

  • B. Kuzmanović Elabjer
  • M. Bušić
  • D. Miletić
  • M. Bjeloš
  • N. Vukojević
  • D. Bosnar
Original Article
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Abstract

Purpose

To evaluate the efficacy of standardized A-scan echography (ASE) complementing ultrasound biomicroscopy (UBM) to propose the most efficient method as grounds for the diagnosis, treatment, and follow-up of anterior eye-segment tumors.

Methods

The inclusion criteria were tumors of the ciliary body and peripheral choroidal tumors, whose anterior border could not be visualized with a 10 MHz ultrasound probe. The largest basal dimension and the highest prominence of the tumor were measured with a UBM Lin 50 probe. A standardized A-scan examination determined the tumor’s thickness and internal reflectivity. Thus, tissue differentiation led to a standardized echography-based diagnosis (SED).

Results

The study included 13 patients. SED was achieved in all examined tumors. The smallest thickness of the tumor of the ciliary body enabling SED was only 1.78 mm. The highest prominence of the tumor (3.66 ± 1.39 mm) was generally larger than its thickness (3.30 ± 1.71 mm).

Conclusion

When approaching ciliary body tumors, both ASE and UBM should be performed, the former to accurately differentiate the tumor and measure its height, and the latter to delineate anterior tumor margins and iris involvement. Standardized echography-based diagnosis was grounds for further evaluation and/or treatment in this case series. The highest prominence of the ciliary body tumor perpendicular to the sclera as evidenced by UBM was generally higher than the thickness obtained with standardized echography. Hence, we propose ASE thickness to be the grounds for staging the severity of ciliary body tumors in the algorithm for their management.

Keywords

Radiation plaque treatment Standardized ultrasonography Tissue differentiation Uveal tumors Ultrasound biomicroscopy 

SOMMARIO

Obiettivo

Valutare l’efficacia dell’ecografia standardizzata A-scan (ASE) integrandola con la biomicroscopia ad ultrasuoni (UBM) per proporre il metodo più efficiente come base per diagnosi, trattamento e verifica dei tumori del segmento oculare anteriore.

Metodi

Sono stati inclusi pazienti con tumori del corpo ciliare e tumori della coroide periferici il cui bordo anteriore non poteva essere visualizzato con la sonda ad ultrasuoni 10 MHz. La dimensione basale maggiore e la sporgenza più alta del tumore sono state misurate con la sonda UBM Lin 50. L’esame ecografico standardizzato A-scan è stato utilizzato per determinare lo spessore e la riflettività interna del tumore. Pertanto, la differenziazione del tessuto ha portato alla diagnosi basata sull’ecografia standardizzata (SED).

Risultati

Lo studio ha coinvolto 13 pazienti. La SED è stata effettuata in tutti i tumori esaminati. Lo spessore minimo del tumore del corpo ciliare rilevato dalla SED era di soli 1,78 millimetri. La sporgenza maggiore del tumore (3,66 ± 1,39 millimetri) era generalmente più grande del spessore del tumore (3,30 ± 1,71 millimetri).

Conclusione

Quando ci si approccia allo studio dei tumori del corpo ciliare si devono tenere in considerazione entrambi i metodi ASE e UBM, il primo per differenziare accuratamente la tipologia di tumore e la sua altezza, il secondo per delineare i margini della parte anteriore dello stesso e per quel che riguarda il coinvolgimento dell’iride. La diagnosi basata sull’ecografia standardizzata è stata la base per un’ulteriore valutazione e/o trattamento in questa serie di casi. Come evidenziato da UBM, la più alta prominenza del tumore ciliare perpendicolare alla sclera era generalmente più elevata dello spessore rilevato con l’ecografia standardizzata. Di conseguenza proponiamo che lo spessore (rilevato col metodo) ASE funga da base per testare la severità del tumore del corpo ciliare nell’algoritmo della loro gestione.

Notes

Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2018

Authors and Affiliations

  • B. Kuzmanović Elabjer
    • 1
  • M. Bušić
    • 1
  • D. Miletić
    • 1
  • M. Bjeloš
    • 1
  • N. Vukojević
    • 2
  • D. Bosnar
    • 1
  1. 1.Faculty of MedicineUniversity Eye Clinic, Josip Juraj Strossmayer University of Osijek, University Hospital “Sveti Duh”ZagrebCroatia
  2. 2.University Eye Clinic, University Hospital Centre ZagrebZagrebCroatia

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