Multimodal Diagnostic Approach to Choroidal Tumors in the Ocular Oncology Clinic at the International Vision Clinic of Ecuador (CIVE)

Authors

DOI:

https://doi.org/10.61708/8q429506

Keywords:

ocular neoplasms, choroidal tumors, uveal melanoma, multimodal imaging, TFSOM-DI

Abstract

Background: choroidal tumors encompass a spectrum of benign and malignant lesions, including nevi, hemangiomas, and uveal melanomas. Diagnosis can be challenging, especially in early stages or when biopsy is unavailable. Multimodal imaging, combined with the mnemonic “To Find Small Ocular Melanoma Doing Imaging” (TFSOM-DI), helps identify clinical and imaging features associated with malignancy and supports objective diagnostic decisions. Objective: to assess the association between clinical and imaging findings and malignancy classification at diagnosis in patients with choroidal tumors, through the application of the TFSOM-DI model in an ocular oncology center in Ecuador. Materials and Methods: an observational, cross-sectional, and retrospective study was performed by reviewing medical records of patients seen between January 2022 and May 2025 at the International Vision Clinic of Ecuador (CIVE). Twenty-eight patients (29 eyes) with clinically and imaging- confirmed choroidal tumors were included. Imaging modalities comprised fundus photography, optical coherence tomography (OCT), autofluorescence, B-scan ultrasonography, and angiography (in selected cases). Descriptive and inferential statistics were applied (p < 0.05). Results: 41.4% of the cases were malignant (uveal melanoma) and 58.6% were benign (nevi and hemangiomas). Significant associations were observed between malignancy and tumor thickness > 2 mm (p = 0.0287), subretinal fluid (p = 0.0007), and orange pigment (p = 0.0208). Basal diameter > 5 mm showed a non-significant trend (p = 0.139). Malignant tumors presented worse visual acuity at diagnosis. Conclusion: the combined use of multimodal imaging and the TFSOM-DI mnemonic enabled identification of clinical-imaging patterns associated with malignancy, supporting its role as a diagnostic stratification tool in clinical practice. This approach may enhance evaluation and management of choroidal tumors in resource-limited settings where histopathologic confirmation is not always available.

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Author Biographies

  • Tatiana Estefanía Muñoz Flores, Catholic University of Santiago de Guayaquil

    La Dra. Tatiana Muñoz Flores es médico cirujano, egresada del posgrado de Oftalmología,  de la Universidad Católica de Santiago de Guayaquil y de la Clínica Internacional de la Visión del Ecuador (CIVE). Durante su residencia, ha desarrollado una sólida formación clínica y quirúrgica en córnea, cirugía refractiva y oncología ocular.

    Ha participado activamente en proyectos de investigación sobre tumores coroideos, superficie ocular y cirugía de catarata, con presentaciones en congresos nacionales e internacionales. Su trabajo académico incluye publicaciones en revistas científicas, participación como docente en talleres de Wet Lab y colaboraciones en iniciativas de educación médica continua.

    Su principal línea de investigación actual es la aplicación de imagenología multimodal y criterios clínicos estructurados (TFSOM-DI) para la estratificación del riesgo de malignidad en tumores intraoculares, con especial énfasis en la población latinoamericana.

    Además de su formación académica, la Dra. Muñoz ha representado a su institución en foros científicos internacionales, ha realizado rotaciones en centros de referencia y ha colaborado en actividades de vinculación con la comunidad en el área de prevención de ceguera.

    Su interés profesional se centra en el diagnóstico y tratamiento integral de la patología corneal y tumores intraoculares, con la visión de contribuir al desarrollo de la subespecialidad en Ecuador y fortalecer la investigación clínica en oftalmología en la región.

  • Juan Pablo Gutierrez Mendoza, Catholic University of Santiago de Guayaquil

    Posgrado de Oftalmología, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.

  • Verónica Lissette Gavin Barros, Catholic University of Santiago de Guayaquil

    Posgrado de Oftalmología, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.

  • María Carolina Muñoz Toral, Catholic University of Santiago de Guayaquil

    Posgrado de Oftalmología, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.

  • Juan Iturralde Irahola, Clínica Internacional De La Visión De Ecuador

    Departamento de Retina, Vítreo y Oncología Ocular, Clínica Internacional de la Visión del Ecuador (CIVE), Daule, Ecuador.

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Published

2025-11-13

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Vol. 3 No. 2 (2025)

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Original article

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Copyright (c) 2025 Copyright: © Los autores. Publicado por Gaceta Médica JBG.

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How to Cite

1.
Muñoz Flores TE, Gutierrez Mendoza JP, Gavin Barros VL, Muñoz Toral MC, Iturralde Irahola J. Multimodal Diagnostic Approach to Choroidal Tumors in the Ocular Oncology Clinic at the International Vision Clinic of Ecuador (CIVE). Gac Med JBG [Internet]. 2025 Nov. 13 [cited 2026 Mar. 5];3(2):1-8. Available from: https://gacetamedicajbgmedec.biteca.online/index.php/GMJBG/article/view/78