UBM provides high-quality images of anterior segment tumor margins

Ophthalmology. 2011;118(7):1297-1302.

Issue: September 25, 2011

Ultrasound biomicroscopy offered better visualization of anterior segment tumors than did anterior segment optical coherence tomography, a study found.

“We have found that AS-OCT is a useful tool for evaluation of superficial, nonpigmented lesions of the eye, such as conjunctival tumors. However, AS-OCT suffers from poor resolution with shadowing in cases of large or pigmented lesions. … It seems that UBM has a better ability to penetrate through the lesion into the eye, providing better images of the posterior margin as well as the entire tumor configuration compared with AS-OCT.”

The retrospective study included 200 eyes of 200 patients with anterior segment tumors. Mean patient age was 50 years.

Tumors were identified in the iris stroma in 96 eyes, the iris pigment epithelium in 44 eyes, the iris and ciliary body in 32 eyes, the ciliary body in 14 eyes, the conjunctiva in six eyes and the sclera in four eyes and other locations in four eyes. The most common diagnoses were nevus, melanoma and cyst.

All tumors were evaluated with ultrasound biomicroscopy (OPKO Instrumentation/OTI) and Visante AS-OCT (Carl Zeiss Meditec).

Study results showed high overall image quality in 80% of UBM images and 68% of AS-OCT images. Visualization of tumor margins was deemed adequate in 95% of UBM images and 40% of AS-OCT scans.

UBM provided better image resolution in the posterior margin, while AS-OCT offered better resolution in the anterior margin, the authors reported.

The Bianciotto et al study comparing ultrasound biomicroscopy (UBM) to anterior segment optical coherence tomography (AS-OCT) combines the attributes of a well-designed clinical study with the benefits of large case numbers and superb images. A practitioner whose office can offer both modalities to their patients can definitely benefit from the results of this study.

While UBM is more labor-intensive and requires a supine patient and a water bath, AS-OCT allows the patient to remain seated with no contact to the ocular surface. The choice of modality depends on what the practitioner wants to image. AS-OCT was shown to be better for imaging the anterior surface of tumors, the anterior segment anatomy and conjunctival lesions. UBM was better for imaging the entire tumor configuration, especially the posterior margin of the tumor. These diagnostic images are important in determining future therapeutic choices.

– Charles B. Slonim, MD
OSN Oculoplastic and Reconstructive Surgery Board Member
Disclosure: Dr. Slonim has no relevant financial disclosures.