The EOG and choroidal malignant melanomas

Abstract

Fifty-four patients with a unilateral pigmented choroidal lesion were studied with electrooculography (EOG). Eighteen of 21 patients with histologically proven (13) or presumed (8) malignant tumors of the choroid had light peak-dark trough ratios (L/D) less than or equal to 150. Seventeen of 21 patients in the malignant group had an interocular L/D difference (L/Dd) greater than or equal to 23%, whereas only one of 33 patients with nevi or a condition simulating a nevus had a percent difference of such magnitude. Combining the L/D and L/Dd criteria resulted in a 98% accurate double-blind prediction of the final clinical/pathological results. The EOG is an objective, noninvasive test useful in the diagnosis of choroidal malignant melanomas.

The electro-oculogram as an aid in the diagnosis of uveal melanoma

“…This confirms the findings of Bohar and Farkas [1]. The occurrence of a retinal detachment together with a melanoma was of no influence on the EOG, which is in agreement with the similar findings of other authors [2,3,5,8,9], and could in most cases be differentiated from a rhegmatogenous retinal detachment. A reasonably good differentiation could be made between melanomas and retinal detachments.…”

“…Therefore an acceptable differentiation can be made between a choroidal melanoma and a choroidal naevus. Staman et al [9] stated that by selecting those values with a Lp/Dt ~< 1.50 and a difference in the ratio…”

“…Several authors found no influence of tumour volume on the EOG [5,8,9]. Others found that the (Lp/Dtnor -Lp/Dtpa) i> 23% Lp/Dtpa they could predict the occurrence of a melanoma or a naevus with an accuracy of 98%.…”

“…In most patients an abnormal EOG was found. Several authors described an additional effect of retinal detachment on the EOG in eyes with malignant melanoma [5,8,9]. Some efforts have been made in order to differentiate between patients with choroidal melanomas and patients with choroidal naevi [4,5,9].…”

The slow electrooculogram oscillation in malignant choroidal melanoma

“…The EOGs appeared to be involved to a higher degree than they corresponded to the extent of the tumor and to the extent of overlying retinal detachment. Staman and associates [2] correlated the reduction of the light peak to dark trough ratio to the volume and Jones and associates [3] to the size of the tumor. Ponte and Lauricella [4] and Staman and associates [2] proposed a deterioration of noninvolved areas of the retinal pigment epithelium.…”