Br J Ophthalmol 1998;82:159-161 ( February )
Choroidal metastases and choroidal melanomas: comparison of
ultrasonographic findings
Beate Sobottka,a
Torsten Schlote,b
Hans G Krumpaszky,c
Ingrid Kreissiga
a Ophthalmology III, University of Tuebingen,
Germany, b Ophthalmology I,
University of Tuebingen, Germany, c Department
of Medical Information Processing, University of Tuebingen, Germany
Correspondence to: Beate Sobottka,
MD, University Eye Clinic of Tuebingen, Schleichstrasse 12, 72076 Tuebingen, Germany.
Accepted for publication 27 August 1997
AIMS
The purpose of the study was to analyse,
whether the shape and the height to base ratio in B-scan
ultrasonography are appropriate to differentiate choroidal melanomas
from metastases.
METHODSBetween 1991 and 1996 16 eyes of 16 patients with choroidal metastases from breast carcinomas and 66 eyes
of 66 patients with choroidal melanomas were evaluated
ultrasonographically. The diagnosis of choroidal melanoma has been
confirmed histologically in all eyes. Irradiated tumours were excluded
from the study. Fisher's exact test and 
2 test were
used for statistical analysis.
RESULTSChoroidal metastases demonstrated a
significantly lower height to base ratio in B-scan (mean 0.18, SD 0.08)
than melanomas (mean 0.6 (0.16); p < 0.001). A polygonal tumour
surface was significantly more frequent in metastases (13 out of 16 metastases and in six out of 66 melanomas, p < 0.001). A choroidal
excavation could be demonstrated in 38 melanomas and in no metastatic
tumour (p < 0.001). The reflectivity was significantly higher in
metastases than in melanomas.
CONCLUSIONThe combined use of height to base
ratio and reflectivity enables a highly significant discrimination
between choroidal melanomas and metastases from the breast, thus
probably constituting appropriate variables for the clinical differentiation.
Keywords:
choroidal melanoma;
choroidal metastasis;
ultrasonography
© 1998 by British Journal of Ophthalmology
