In this study, we aimed to identify the features of indeterminate choroidal melanocytic lesions visualized on optical coherence tomography angiography (OCTA) and to identify the predictors of growth. We retrospectively evaluated 86 patients with indeterminate lesions treated at our centre from 2016 to 2021. Clinical management involved active surveillance followed by brachytherapy if growth was detected. The lesions were classified into two groups according to whether they grew (small melanomas) or remained stable (choroidal nevi). Growth was detected in 19 (22.1%) lesions. All patients underwent OCTA at baseline. These images were compared to identify the possible predictors of growth. Significant between-group differences were observed in thickness (p= 0.00), greatest basal diameter (p= 0.00), number of risk factors (p= 0.00), symptoms (p= 0.001; relative risk [RR]: 4.3), orange pigment (p= 0.00; RR: 6.02), and ultrasonographic hollowness (Kappa sign);p= 0.000; RR: 5.3). The melanomas had significantly more vessels with a diameter ≥ 76.3 µm (p= 0.02; RR: 2.46). The time to growth in these lesions was significantly shorter (p= 0.05) than in lesions with smaller vessels. These findings show that vessel diameter quantified by OCTA can help differentiate between choroidal nevi and small melanomas, when considered together with clinical risk factors.
本研究旨在通过光学相干断层扫描血管成像（OCTA）识别不确定性脉络膜黑色素细胞性病变的特征，并探究其生长预测因子。我们回顾性分析了2016年至2021年间在本中心接受治疗的86例不确定性病变患者。临床管理方案为主动监测，若发现病变生长则进行近距离放射治疗。根据病变是否生长，将病灶分为两组：生长组（小型黑色素瘤）与稳定组（脉络膜痣）。结果显示，19例（22.1%）病灶出现生长。所有患者均在基线期接受OCTA检查，通过对比影像资料分析生长预测因子。两组在厚度（p=0.00）、最大基底直径（p=0.00）、危险因素数量（p=0.00）、临床症状（p=0.001；相对风险[RR]：4.3）、橙色色素（p=0.00；RR：6.02）及超声空泡征（Kappa征；p=0.000；RR：5.3）方面存在显著差异。黑色素瘤组中直径≥76.3µm的血管数量显著更多（p=0.02；RR：2.46），且此类病变的生长时间显著短于小血管病变（p=0.05）。研究表明，结合临床危险因素，通过OCTA量化血管直径有助于鉴别脉络膜痣与小型黑色素瘤。
肿瘤(癌症)患者之家