June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Magnetic resonance imaging features of the optic nerve in enucleated retinoblastoma patients
Author Affiliations & Notes
  • Ramon Lee
    The Vision Center at Children's Hospital Los Angeles, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California, United States
    USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California, United States
  • Jesse L Berry
    The Vision Center at Children's Hospital Los Angeles, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California, United States
    USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California, United States
  • Ingy Madi
    The Vision Center at Children's Hospital Los Angeles, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California, United States
    USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California, United States
  • Emily Zolfaghari
    The Vision Center at Children's Hospital Los Angeles, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California, United States
    USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California, United States
  • Jonathan W Kim
    The Vision Center at Children's Hospital Los Angeles, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California, United States
    USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Ramon Lee, None; Jesse Berry, None; Ingy Madi, None; Emily Zolfaghari, None; Jonathan Kim, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3334. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Ramon Lee, Jesse L Berry, Ingy Madi, Emily Zolfaghari, Jonathan W Kim; Magnetic resonance imaging features of the optic nerve in enucleated retinoblastoma patients. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3334.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : The aim of this retrospective review was to determine the role of gadolinium-enhanced magnetic resonance imaging in the assessment of optic nerve of retinoblastoma patients post-enucleation by detecting signs of contrast enhancement and/or thickening along the cut end of the nerve.

Methods : Eligible patients underwent enucleation for retinoblastoma between January 2008 and December 2015. Overall, 90 enucleated eyes for 88 patients were included. Post-contrast MRI of the orbit was performed both pre-enucleation, for evaluation of optic nerve and trilateral disease, and post-enucleation for routine screening. The primary outcome measures were contrast enhancement along the cut end of the optic nerve, abnormal optic nerve thickening, presence of orbital disease, and/or trilateral retinoblastoma post-enucleation. Based on radiologist assessment, optic nerve enhancement was categorized into 3 subgroups: mild, moderate, or severe. Tumor extension into the optic nerve on histopathology was also assessed and categorized as pre- or post-laminar invasion.

Results : Overall, 41 of 50 eyes (82%) of post-enucleation patients demonstrated contrast enhancement along the cut end of the optic nerve post-enucleation at a mean interval of 10 months. Of these, 20 demonstrated moderate enhancement and 7 mild; the severity of enhancement was not described for 14 patients. The enhancement was noted to be stable or resolved on follow-up imaging. Among the 88 patients, 38 patients received systemic chemoreduction with CEV pre-enucleation; there was no association between chemotherapy administration and optic nerve enhancement. Histopathologic post-laminar optic nerve invasion was reported in 6 eyes and pre-enucleation optic nerve enhancement was detected in 3 of these eyes. No child required a biopsy secondary to optic nerve findings. None of these patients were found to have subsequent orbital or metastatic disease at last exam under anesthesia (average 13 months, range 1-59) or last follow-up visit (average 29 months, range 1-71).

Conclusions : Optic nerve contrast enhancement on follow-up MRI post-enucleation for retinoblastoma is a common finding and appears to be consistent with normal post-surgical scarring and granulation tissue, and not active tumor. The presence or absence of post-enucleation enhancement did not correlate with pre-enucleation chemotherapy or the presence of optic nerve invasion on histopathology.

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

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×