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How do we know it is melanoma ~
Melanoma within the eye is diagnosed during an examination of the eye by an ophthalmologist. Confirmation of the tumor by an ocular oncologist (eye cancer specialist) is advised as melanoma can resemble other eye tumors. Melanoma shows a typical color, shape, and location as well as several other classic features. Imaging of the tumor is important to confirm these features and learn more about the blood supply to the tumor.
What is diagnostic imaging of the eye ~
Diagnostic imaging of the eye are a series of tests that confirm the presence of melanoma and document its size to assist in treatment. These techniques include transillumination, gonioscopy, fundus and slit lamp photography, external photography, wide angle fundus photography, fluorescein angiography (IVFA), indocyanine green angiography (ICG), ultrasonography, ultrasound biomicroscopy (UBM), optical coherence tomography (OCT), standard scanning laser ophthalmoscopy (SLO), wide angle scanning laser ophthalmoscopy (Optos), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and other available tests.
Transillumination
Gentle and safe technique of directing a bright light through the wall of the eye to visualize the shadow cast by a tumor within the eye. This allows a 2 dimensional view of the exact location of a peripheral tumor.
Gonioscopy
Specially mirrored lens (gonioscopy lens) is placed on the anesthetized cornea and the doctor views the deep structures in the angle of the front of the eye near the iris. This can provide information on tumor extension into hidden areas of the eye.
Photography
There are several ways to photograph the eye. High resolution digital cameras are used to view the structures in the front and back of the eye. These provide accurate images of the tumor, even if it is deep in the back of the eye. Photographs of the eye and tumor are important for documenting the tumor, its relationship to visually important structures, planning treatment, and for comparison after treatment is completed.
Panoret wide angle photography
Wide angle contact digital camera with advanced technology to image nearly the entire back of the eye.
Fluorescein angiography (IVFA)
Test in which a yellow dye (fluorescein) is injected intravenously and blue light photography is used to image the filled vessels. This test allows a better understanding of retinal blood flow near the tumor.
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Indocyanine green angiography (ICG)
Test in which a green dye (indocyanine) is injected intravenously and red light photography is used to image the filled vessels. This test allows a better understanding of choroidal blood flow near the tumor.
Ultrasonography
Silent sound waves to provide a 2 or 3 dimensional cross section of the back of the eye. Tumor thickness and volume is measured accurately with this method.
Ocular ultrasound
Ultrasound of an eye with a choroidal melanoma and overlying retinal detachment
Ultrasound biomicroscopy (UBM)
Silent sound waves at high frequency to image the front of the eye.
Optical coherence tomography (OCT)
Comfortable beam of light to measure the appearance and thickness of the retina.
Scanning laser ophthalmoscopy (SLO)
Method of using comfortable light to scan the back of the eye and take a picture without a bright flash of light.
Wide angle scanning laser
Comfortable scanning laser (Optos) with advanced technology to image nearly the entire back of the eye without using a bright flash of light.
Computed tomography (CT)
Radiology test to image a cross section of a part of the body using x-ray technology.
Magnetic resonance imaging (MRI)
Radiology test to image a cross section
of a part of the body using magnetic technology. It is not recommended if a patient has a pacemaker or implanted metal device such as a clip for a brain aneursym.
Positron emission tomography (PET)
Radiology test in which a dye is injected and it attaches to cells that are actively growing and dividing, suggestive of tumor cells.
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