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Retinal vascular alterations associated with dome-shaped and mushroom-shaped choroidal melanomas

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Abstract

Purpose: Retinal vascular abnormalities are associated with choroidalmelanoma. Although tumor ischemia, resulting in soluble angiogenic factorproduction, is a proposed etiology of these abnormalities, other sources ofischemia may also contribute. Mushroom-shaped choroidal melanomas haveincreased loss of the overlying choriocapillaris and increased subretinal fluidwhen compared to dome-shaped tumors; factors that may result in outer retinalischemia, angiogenic factor production and resultant retinal vascular abnormalities.The differing amounts of retinal vascular abnormalities overlying dome-shapedcompared to mushroom-shaped melanomas were determined to evaluate thishypothesis. Methods: Retinal vascular abnormalities observed on fluoresceinangiograms of eyes with choroidal melanoma were compared to the tumor configuration and presence of subretinal fluid. Results: 23 eyes of 22 patients were included in the study. Retinal vascular abnormalities observed included dilated capillaries, telangiectatic capillaries, capillary nonperfusion, microaneurysms, neovascularization, lipid exudation and late staining of dye within the retina. Retinal vascular abnormalities were present in 4 of 14 eyes with dome-shaped tumors (29%) and in 8 of 9 eyes with mushroom-shaped tumors (89%). (Fisher's Exact Test, p=0.009). Retinal vascular abnormalities were present in 2 of 10 eyes without subretinal fluid (20%) and in 10 of 13 eyes with subretinal fluid (77%). (Fisher's Exact Test, p = 0.012). Conclusions: Retinal vascular abnormalities are associated with mushroom-shaped choroidal melanomas more commonly than dome-shaped tumors. Outer retinal ischemia may result from choriocapillaris loss or the presence of subretinal fluid, contributing to soluble angiogenic factor production and resultant retinal vascular abnormalities in these eyes. Summary statement: Retinal vascular abnormalities are associated with mushroom-shaped choroidal melanomas more commonly than dome-shaped tumors. These retinal vascularabnormalities may be related to an increase in outer retinal ischemia associated withmushroom-shaped tumors.

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References

  1. Cantrill HL, Cameron JD, Ramsey RC, Knobloch WH. Retinal vascular changes in malignant melanoma of the choroid. American Journal of Ophthalmology 1984; 97: 411–8.

    PubMed  Google Scholar 

  2. Michael JC, Venecia Gd. Retinal trypsin digest study of cystoid macular edema associated with peripheral choroidal melanoma. American Journal of Ophthalmology 1994; 119: 152–6.

    Google Scholar 

  3. Vinores SA, Kuchle M, Mahlow J, et al. Blood-ocular barrier breakdown in eyes with ocular melanoma; a potential role for vascular endothelial growth factor/vascular permeability factor. American Journal of Pathology 1995; 147: 1289–97.

    PubMed  Google Scholar 

  4. Shweiki D, Itin A, Soffer D, Keshet E. Vascular endothelial growth factor induced by hypoxia may mediate hypoxiainitiated angiogenesis. Nature 1992; 359: 843–5.

    PubMed  Google Scholar 

  5. Stitt AW, Simpson DAC, Boocock C, et al. Expression of vascular endothelial growth factor (VEGF) and its receptors is regulated in eyes with intra-ocular tumours. Journal of Pathology 1998; 186: 306–12.

    PubMed  Google Scholar 

  6. Anonymous. Histopathologic characteristics of uveal melanomas in eyes enucleated from the Collaborative Ocular Melanoma Study. COMS report no. 6. American Journal of Ophthalmology 1998; 125: 745–66.

  7. Zimmerman LE: Malignant melanoma of the uveal tract. In: Spencer WH, ed. Ophthalmic Pathology, 3 ed, vol 3. Philadelphia: W. B. Saunders Co., 1986; 2072–139.

    Google Scholar 

  8. Holladay J. Proper method for calculating average visual acuity. Journal of Refractive Surgery 1997; 13: 388–91.

    PubMed  Google Scholar 

  9. Ashton N. Retinal micro-aneurysms in the non-diabetic subject. British Journal of Opthalmology 1951; 35: 189–212.

    Google Scholar 

  10. Oosterhuis JA, Waveren CWv. Fluorescein photography in malignant melanoma. Ophthalmologica 1968; 156: 101–116.

    PubMed  Google Scholar 

  11. Rubinstein K. Differential diagnosis of malignant melanoma. Transactions of the Ophthalmological Societies of the United Kingdom 1967; 87: 447–56.

    PubMed  Google Scholar 

  12. Theodossiadis G. Retinal and choroidal vascular involvement in cases of malignant melanoma of the choroid; a study based on fluorescein angiography. Ophthalmologica 1971; 163: 383–92.

    PubMed  Google Scholar 

  13. Vine AK. Choroidal melanoma with disc and retinal neovascularization. Retina 1983; 3: 118–20.

    PubMed  Google Scholar 

  14. Favard C, Ortega N, Bayard F, Plouet J. Vascular endothelial growth factor and retinal neovascularisation: a new therapeutic approach for diabetic retinopathy. Diabetes & Metabolism 1996; 22: 268–73.

    Google Scholar 

  15. Brownstein S, Orton R, Jackson B. Cystoid macular edema with equatorial choroidal melanoma. Archives of Ophthalmology 1978; 96: 2105–7.

    PubMed  Google Scholar 

  16. Meyer K, Augsburger JJ. Independent diagnostic value of fluorescein angiography in the evaluation of intraocular tumors. Graefe's Arch Clin Exp Ophthalmol 1999; 237: 489–94.

    Google Scholar 

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Authors and Affiliations

  1. Mason Eye Institute, University of Missouri, Columbia, MO, USA

    Dean P. Hainsworth, Kaley C. Todd, Nicholas T. Ranson & James W. Gigantelli

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  1. Dean P. Hainsworth
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  2. Kaley C. Todd
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  3. Nicholas T. Ranson
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  4. James W. Gigantelli
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Hainsworth, D.P., Todd, K.C., Ranson, N.T. et al. Retinal vascular alterations associated with dome-shaped and mushroom-shaped choroidal melanomas. Int Ophthalmol 24, 141–146 (2001). https://doi.org/10.1023/A:1021170402679

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  • DOI: https://doi.org/10.1023/A:1021170402679

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