Abstract

Purpose: A multimodal imaging study to differentiate amelanotic choroidal lesions – choroidal granuloma, amelanotic melanoma, and choroidal metastasis.
Methods: Retrospective chart review.
Results: Nine eyes with granuloma, 12 eyes with melanoma, and 22 with metastasis were included. On B-scan USG the mean base-to-height ratio was more in metastasis as compared to melanoma eyes. A-scan USG showed medium to high reflectivity in granuloma and metastasis eyes and low reflectivity in melanoma eyes . On ICG-A, all metastasis eyes had hyperfluorescent lesions while melanoma and granuloma eyes had hypofluorescent lesions. On OCT, all melanoma eyes had larger choroidal elevation, granuloma eyes had a smooth choroidal elevation, and metastasis eyes had a lumpy-bumpy choroidal elevation.
Conclusion: Multimodal imaging using ICG-A, USG and OCT revealed some distinct characteristics for amelanotic choroidal lesions which could help to reach an early diagnosis and appropriate timely referral.