Multimodal approach in the diagnosis of choroidal nevi and melanomas

Background.The multimodal approach plays a key role in the diagnosis and monitoring of nevi and melanomas of the chorioidea. Currently, this approach is being actively developed and demonstrates its effectiveness in clinical practice. Combined use of various diagnostic methods in ophthalmology allows obtaining complete information about the nevi and deciding further tactics of patient management. Purpose. To identify the combination of multimodal imaging risk factors and prognostic value of chorioidal nevus transformation to melanoma. Material and methods. Analysis of patients diagnosed with chorioideal nevus and melanoma. All patients underwent standard ophthalmologic examination, ophthalmoscopy with Volk 78D non-contact lens, ultrasound (USG), optical coherence tomography (OCT) through the focus of the mass and OCT in angioregime (OCT-A) (Optovue RTVue-100.), wide-field photoregistration and autofluorescence of the ocular fundus (Zeiss Clarus™ 500). Results. Multimodal methods such as: Ultrasound, OCT through the lesion and OCT-A, wide-field photoregistration and ocular autofluorescence allow early detection of nevus transfomation into melanoma. These signs include an increase in the mean diameter and thickness of the mass, the appearance of subretinal fluid on optical coherence tomography, and an increase in lipofuscin autofluorescence. According to the literature, initial MX on OCTA examination is characterized by: irregular large-mesh vasculature in the outer nuclear layer and in the choriocapillary layer. Conclusion.A multimodal approach is used to document and diagnose chorioideal masses, to detect growth and progression at followup visits, and therefore to identify risk factors for transformation.