Ultrasound biomicroscopy examination of anterior uveal tumors: information on location and size only?

The aim of the study was to assess whether ultrasound biomicroscopy (UBM) examination of anterior uveal tumors could help in tissue differentiation. Five anterior uveal tumors in five patients underwent UBM (Paradigm P45, 50 MHz) examination prior to fine needle aspiration (FNA) of the lesion; two melanomas, one nevus, one metastatic carcinoma, and one bilateral iris lymphoma were cytologically diagnosed. Only UBM information was obtained from four small non-growing lesions consistent with iris nevi. Four ciliary body pigmented tumors elevated by 4 to 6 mm were examined both with UBM and immersion standardized echography (Cinescan S, Quantel Medical). UBM showed high reflective iris subsurface in all iris nevi. Of the FNA verified iridociliary pigmented tumors, the iris pigment epithelium was found to be indistinct in iridociliary melanoma only. Iridociliary melanoma, nevus and metastatic carcinoma showed angle invasion and similar acoustic pattern and reflectivity on UBM examination. Multiple iris masses were imaged in lymphoma and metastatic carcinoma. Two ciliary body low to medium reflective and two ciliary body high reflective tumors on standardized echography, consistent with ciliary body melanoma and melanocytoma, were plaqued or observed for four and thirteen years; UBM was informative for superficial margins and angle invasion only. In conclusion, UBM was very useful for location and size of small anterior uveal tumors, but could not help in tissue differentiation of iridociliary tumors. Multiple iris lesions were found in iridociliary lymphoma or metastatic carcinoma only. Standardized echography allowed for tissue differentiation in at least 4-mm thick ciliary body pigmented