Abstract
Purpose: :
To identify unique characteristics of spectral-domain optical coherence tomography (SD-OCT) in patients with retinal astrocytomas.
Methods: :
A retrospective, descriptive case series of two patients diagnosed with retinal astrocytoma underwent complete ophthalmological examination, infrared (IR) fundus photography, fundus autofluorescence (FAF) imaging, fluorescein angiography and SD-OCT (Spectralis, Heidelberg Engineering, Germany). Obtained SD-OCT images were then compared to pathology pictures.
Results: :
Two eyes of two patients diagnosed with retinal astrocytoma were included in the study. One was a 47-year old African American woman with neurofibromatosis type 2 (NF2) who presented with a unifocal lesion superonasal to the fovea in the left eye. The other was a 17-year old Caucasian girl with tuberous sclerosis who presented with extrafoveal multifocal retinal astrocytomas nasally and along inferotemporal arcade in her right eye. All lesions had similar characteristics - FAF showed a dense area of hypofluorescence (in the area of the astrocytoma) with adjacent areas of hyperfluorescence. Fluorescein angiography showed an early ‘lacy’ hyperfluorescence with late intense staining. SD-OCT revealed a dome-shaped, hyperreflective lesion arising from the superficial nerve fiber layer with shadowing of the rest of the retinal layers, probably because of the calcium in the tumor. There were multiple lacunae in the astrocytoma itself with a prominent overlying vitreous condensation. Additionally, in the patient with NF2, there were cystic changes in the retinal layers in the perifoveal area.
Conclusions: :
The SD-OCT, angiographic and FAF features of retinal astrocytoma closely resemble the pathology of the astrocytoma. SD-OCT provides a ‘live histology’ of the astrocytoma and adds to the understanding of the pathology of the disease.
Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • retina • astrocyte