The Effectiveness of Ultrasound Biomicroscopic and Anterior Segment Optical Coherence Tomography in the Assessment of Anterior Segment Tumors: Long-Term Follow-Up

Abstract

Background. Differential diagnosis and follow-up of small anterior segment tumors constitute a particular challenge because they determine further treatment procedures. The aim of this study was to evaluate the efficacy of the UBM (ultrasound biomicroscopy) and AS-OCT (anterior segment optical coherent tomography) in distinguishing different types of anterior segment lesions. Methods. It was a retrospective, noncomparative study of case series of 89 patients with the suspicion of anterior segment tumor referred to the Ophthalmology Clinic, Medical University of Białystok, Poland, between 2016 and 2020. UBM was used to assess tumor morphology including height, location, and internal and external features. In cases in which UBM did not provide enough data, the AS-OCT images were analyzed. The data on demographics, best corrected visual acuity (BCVA), intraocular pressure (IOP), and rate of complications were also collected. Patients were followed up from 1 to 48 months. Results. The mean observation period was 26.61 ± 16.13 months. Among the patients, there were 62 women and 27 men at a mean age of 55.59 ± 19.48 (range: from 20 to 89 years.) The types of tumors were cysts (41%), solid iris tumors (37.1%), ciliary body tumors (7.9%), peripheral anterior synechiae (PAS 3.4%), corneal tumors (4.5%), and others (5.6%). Patients with cysts were younger than patients with solid iris tumor (p=0.002). Women had a cyst as well as solid iris tumor more frequently than men, but less often a ciliary body tumor (p<0.05). The horizontal size of tumor was positively correlated with patients' age (rs = 0.38 and p=0.003) and negatively correlated with visual acuity (rs = -0.42 and p=0.014). During the 4 years of diagnosis, only 2.2% of lesions exhibited growth (growth rate of 0.02 mm per year). Among 15 cases in which visualization with UBM was not satisfactory (mostly iris nevi), AS-OCT was helpful in diagnosis of 13 patients. Conclusions. Both UBM and AS-OCT are effective methods in detection and diagnosis of tumors of the anterior eye segment, but in some cases, AS-OCT adds additional value to the diagnosis. Many lesions can be managed conservatively because they did not demonstrate growth during 4 years of the follow-up period.