Immediately after enucleation, the eyes were brought to the laboratory for spectroscopic analysis. The tumors were grouped according to the TNM classification, 11 and the degree of retinal detachment was scored semiquantitatively from 1 to 3. Prior to surgery, ophthalmoscopy, ultrasonography, fluorescein angiography, and magnetic resonance imaging revealed the location, size, and shape of the tumors, as well as the degree of exudative retinal detachment. 9, the Table) was enucleated 15 months after iodine-125 brachytherapy due to lack of local tumor control. Eight eyes underwent primary enucleation, and one eye (patient no. Nine consecutive patients enucleated for posterior uveal melanoma at the Department of Ophthalmology of Haukeland University Hospital, between January 2010 and June 2011, were included in the study. The objectives of the present work were to evaluate the feasibility of using transscleral optical spectroscopy to analyze both normal and tumor-infiltrated areas of human eyes, and to study the spectral properties of choroidal melanomas in relation to various morphological features. However, significant morphological differences also exist among uveal melanomas in general, which are subclassified into spindle and epithelioid cell types, different stages based on tumor size, and various degrees of pigmentation ranging from amelanotic to darkly pigmented tumors. Owing to morphological characteristics and different contents of melanin and blood, there may be distinct spectral variations between uveal melanomas and other choroidal lesions such as hemangiomas, vasoproliferative tumors, metastases, and choroidal hemorrhages or hematomas. 9, 10 The fine, homogeneous structure of the sclera and the location of various choroidal lesions just underneath it suggest that a transscleral approach is the most appropriate way to perform optical spectroscopy of intraocular tumors. Recently, we reported for the first time the feasibility and results of transscleral optical spectroscopy, which was found to be an accurate method for predicting the content of melanin and hemoglobin in experimental choroidal tumors. The mean diffuse reflection intensity obtained from the spindle cell melanomas was significantly higher than that from the mixed and epithelioid cell melanomas ( P < 0.0001).Īlthough future in vivo studies are required, these data suggest that transscleral optical spectroscopy is a feasible method for identification and morphological assessment of choroidal tumors. A weaker correlation was observed between the amount of hemoglobin-related absorption and the density of intratumoral blood vessels (Spearman's rho = −0.25, P = 0.023). The diffuse reflection spectra from the melanomas showed a strong correlation with the degree of tumor pigmentation (Spearman's rho = −0.87, P < 0.0001). The spectral imprint of hemoglobin was lower and that of water was considerably stronger when compared with the tumor side. The average reflection intensity obtained from the normal side of the eyes was higher than that from the tumors. Comparisons between spectral and morphological parameters were performed by Spearman's rank correlation coefficient and unpaired t-test. The eyes were then processed for histological and immunohistochemical analyses.
Spectroscopic measurements, covering the wavelength range of 400−1100 nm, were sequentially performed over the uveal melanoma and on the opposite (normal) side of each eye. Nine consecutive eyes enucleated for uveal melanoma were examined by transscleral spectroscopy, using a fiber-optic probe that exerted a fixed pressure on the scleral surface. The aims of this study were to use transscleral optical spectroscopy to analyze normal and tumor-infiltrated areas of enucleated human eyes, and to characterize the spectral properties of uveal melanomas in relation to various morphological features.
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