PURPOSE: To evaluate the imaging features of choroidal metastasis using enhanced depth imaging optical coherence tomography (EDI-OCT). METHODS: Enhanced depth imaging optical coherence tomography imaging features of 24 choroidal metastatic tumors with <2.5 mm of thickness on ultrasonography were retrospectively evaluated. RESULTS: Of the 24 tumors, 10 (42%) were located at the macula and 14 (58%) between the macula and equator. Tumor was plateau-shaped in 18 (75%) tumors and dome-shaped in 6 (25%) tumors. On EDI-OCT, choroidal metastasis showed low internal optical reflectivity in 17 (71%) tumors and high internal reflectivity in 7 (29%) tumors. Most common associated features were overlying choriocapillaris thinning in 24 (100%) tumors, shaggy or irregular, elongated photoreceptors in 18 (75%) tumors, subretinal fluid with high-reflective speckles in 16 (67%) tumors, and thickening of retinal pigment epithelium in 9 (37%) tumors. The mean tumor thickness was 854 μm (range, 287-1500 μm) on EDI-OCT and 2064 μm (range, 0-2400 μm) on ultrasonography. After treatment, the mean decrease in tumor thickness was 520 μm (range, 134-917 μm) on EDI-OCT and 714 μm (range, 0-1500 μm) on ultrasonography. Internal optical reflectivity changed from low to high in five tumors. Choriocapillaris thinning and shaggy photoreceptors improved in four and five tumors, respectively. Subretinal fluid resolved in four tumors. CONCLUSION: On EDI-OCT, choroidal metastasis showed overlying choriocapillaris thinning, plateau-shaped tumor, shaggy photoreceptors, and subretinal fluid with high-reflective speckles in more than half of the tumors. Enhanced depth imaging optical coherence tomography was more sensitive than ultrasonography in the evaluation of small metastatic tumors at presentation and after treatment.
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