June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Immediate and Delayed Microstructural Effects of Cryotherapy for Retinoblastoma Imaged by Optical Coherence Tomography
Author Affiliations & Notes
  • Thamolwan Surakiatchanukul
    Ocular Oncology Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Emil Anthony T Say
    Ocular Oncology Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Carol L Shields
    Ocular Oncology Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Thamolwan Surakiatchanukul, None; Emil Anthony Say, None; Carol Shields, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3331. doi:
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      Thamolwan Surakiatchanukul, Emil Anthony T Say, Carol L Shields; Immediate and Delayed Microstructural Effects of Cryotherapy for Retinoblastoma Imaged by Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3331.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To describe immediate and delayed microstructural effects of cryotherapy for retinoblastoma using optical coherence tomography (OCT).

Methods : Descriptive non-comparative case series.

Results : Six eyes of 5 patients with active retinoblastoma were scanned with intraoperative OCT before and after cryotherapy. Of the 6 active tumors, there were 1 newly detected intraretinal tumor (IRT), 4 residual/recurrent IRT, and 1 subretinal seed (SRS). Before treatment, the 5 IRT appeared hyperreflective on OCT and appeared to originate from the middle or outer retina, while the 1 SRS was located in the subretinal space without overlying fluid, edema, or loss of retinal architecture. (Figure 1) All tumors were treated focally with cryotherapy. One IRT was imaged immediately (within 2 minutes) following cryotherapy, and demonstrated increased tumor reflectivity and thickness without cystoid edema or subretinal fluid. (Figure 2) On follow-up, all treated tumors demonstrated regression with reduced thickness, and OCT showed loss of retinal (6/6, 100%) or choroidal (3/6, 50%) structure and no cystoid edema (6/6, 100%). (Figure 1-2) Two (2/6, 33%) tumors appeared having residual internal limiting membrane with cavitary loss of retinal architecture, while 2 (2/6, 33%) had hyperreflective residua over the regressed scar requiring subsequent treatment.

Conclusions : By OCT, cryotherapy for retinoblastoma results in immediate increase in tumor reflectivity and thickness and later tumor regression, as well as retinal and choroidal thinning. Residual active tumor appears as hyperreflective material on OCT and may require further therapy.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

 

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