Tumor Height, Shape and Apex Location
  • Plaque Simulator follows the COMS convention of describing tumor height as the distance between the tumor apex and the inner sclera directly below the apex. Plaque Simulator models the sclera as being 1 mm thick, so the apex of a 5.6 mm tall tumor would be 6.6 mm from the exterior sclera, and also 6.6 mm from the concave face of the plaque assuming the plaque is in contact with the exterior sclera.
  • After digitizing the tumor base in the Retinal Diagram window, enter the tumor height and then choose the shape of the mound and the location of the apex.
TumorHeightUS

Ultrasound is the most reliable method of measuring the tumor height and the shape of the dome.

TumorHeightCT

CT and MR can sometimes be used to measure the tumor height for medium and large tumors if the slice spacing is small and the images are not grainy.


Enter the apex height in the Retinal Diagram window
  • By default, a 2 mm margin is automatically generated surrounding the tumor base. You can change the margin when setting the tumor apex height.
  • In the Retinal Diagram window's tumor controls group, click the Apex button and enter the tumor apex height as measured from ultrasound studies.
    TumorGroup
  • Also in the tumor controls group, select the shape of the tumor (Peak, Dome or Mushroom) as described below.
  • The tumor apex defaults to the geometric center of the tumor base. You can move it elsewhere by enabling Drag Apex cursor mode and dragging it as described below.
    DragApexMode
RDApexSheet
  • Tumor height and margin can also be set in the Standard Tumor sheet which is accessed via the Std. button in the tumor controls group.
RDStdTumorSheet

Dome shaped tumors

In the Retinal Diagram window's tumor controls group, click the Dome button to give the tumor a domed shape.
TumorGroup

USdome1
TumorShapeDome

Peak shaped tumors

In the Retinal Diagram window's tumor controls group, click the Peak button to give the tumor a peaked shape.
TumorGroup

USpeak1
TumorShapePeak

Mushroom shaped tumors

In the Retinal Diagram window's tumor controls group, click the Mushroom button,
TumorGroup and select Stem from the contextual menu (control-click or right mouse button click the mushroom button to display the contextual menu) to give the tumor a mushroom-like shape.
StemMenu

USmushroom1
TumorShapeMushroom

Ball or button shaped tumors

In the Retinal Diagram window's tumor controls group, click the Mushroom button,
TumorGroup and select Ball from the contextual menu (control-click or right mouse button click the mushroom button to display the contextual menu) to give the tumor a ball or button-like shape.
BallMenu

USbutton1
TumorShapeBall

Positioning the tumor apex

In the Retinal Diagram window:

  • Plaque simulator initially places the tumor apex above the geometric center of the tumor base.
TumorApexCentered
TumorApexCenteredMeridian
  • If the tumor base is asymmetric about the apex, set the cursor mode to Drag Apex.
    TumorGroup and then you can click and drag the apex icon (the gray triangle near the middle of the tumor) to the appropriate location. The size of the apex icon is roughly indicative of the tumor height
TumorApexOffset
TumorApexOffsetMeridian