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Eleonora Benedetta Marcheggiani, Chiara Veronese, Lara Enrica Urbini, Filippo Tassi, Alessandro Finzi, Mariachiara Morara, Antonio P Ciardella; En Face OCT imaging of Retinal Astrocytic Hamartoma in 13 cases. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3384.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the features of retinal astrocytic hamartoma using En face spectral domain optical coherence tomography (SD-OCT) imaging.
En face SD-OCT imaging was performed in 12 patients (13 eyes) and tuberous sclerosis was present in all patients (100%). Systematic work-up included retinal examination by SD-OCT (Spectralis Heidelberg Engineering, Heidelberg, Germany) with OCT B-scans and macular mapping. This mapping consisted of 197 transverse sections in a 5.79x5.79 mm2 central retinal area space of 30 µ. Tridimensional reconstruction generated by the pooling of these sections provided a virtual macular brick, trough which 496 shifting sections in the coronal plane resulted in C-scan, or En face OCT, while B-scan is derived from sagittal and transverse sections.
The mean patient age was 28 years, 6 females (50%) and 6 males (50%). The tumor was classified as flat and sessile in 2 cases (15%), semitranslucent and partially calcified in 8 (61%), having a complete mulberrylike calcification in 1 (8%), 1 cavitary (8%) and 1 exudative complicated hamartoma (8%). The mean tumor thickness and basal dimesion by B-scan SD-OCT were respectively 813 µm (median 894; range 389-1310) and 1557 µm (median 1717; range 281-3095). The mean coronal section surface by C-scan was 2,70 mm2 (median 2,85; range 0,30-6,04). By OCT, the tumor showed some degree of retinal disorganization in all 13 cases (100%). The disorganization was limited to the inner retina in 12 (92%), outer retina in 0 (0%) and full retina with no view of deeper layers due to shadowing in 1 (8%). There was gradual transition from a normal retinal to tumor in 12 cases (92%). There was mild retinal traction on the surface of the tumor in 4 (31%), internal mouth eaten optically empty spaces representing intralesional calcification or intratumoral cavities in 8 (61%) and optical shadowing posterior to the tumor in 3 (23%). Other retinal findings included exudates and macular edema in 1 case (8%).
En face OCT imaging gives the advantage of obtaining novel slice orientations. These OCT findings correlate with histopathologic findings, as this tumor typically is composed of randomly oriented elongated fibrous astrocytes with interlacing cytoplasmic processes, which replace the normal retinal microarchitecture. En face OCT is useful in further characterizing the in vivo internal qualities of retinal tumors.
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