UBM for Diagnosing and Managing Anterior Segment Tumors

This study sought to evaluate ultrasound biomicroscopy (UBM) in the management of anterior segment tumors. Investigators conducted a retrospective analysis of medical records of consecutive patients referred to the ocular oncology unit, University of California-San Francisco (UCSF), for suspected anterior segment tumors from 1999 to 2004.

The researchers evaluated 132 eyes from 130 patients, which included 55 uveal melanomas (UM), 21 iris nevi, 30 iris cysts and 26 remaining lesions. Of the melanomas, 45 were also evaluated with conventional A/B-scan. There was 29 percent correspondence between the anatomical structures invaded by melanoma as identified by B-scan vs. disease extent defined by UBM. Ciliary body and peripheral iris involvement by melanomas was significantly more frequently observed by UBM than B-scan. Seven of 30 benign cysts were diagnosed as cystic before UBM evaluation. In three cases, neuroepithelial cysts were associated with intercurrent pathology including iris nevus (two cases) and ciliary body melanoma (one case). Two ciliary body melanomas showed cavitation, including one patient with a pseudocyst. Histopathological correlation was possible in six cases.

The authors believe their results show that UBM is an indispensable tool for managing anterior segment tumors. They maintain that the study demonstrates the superiority of UBM vs. conventional B-scan for the precise localization of uveal melanoma, especially involving the ciliary body and peripheral iris.


SOURCE: Conway RM, Chew T, Golchet P, et al. Ultrasound biomicroscopy: role in diagnosis and management in 130 consecutive patients evaluated for anterior segment tumours. Br J Ophthalmol. 2005 Aug;89(8):950-5.