May 2004
Volume 45, Issue 13
ARVO Annual Meeting Abstract  |   May 2004
Diagnosis of Iris Neovascularization in Retinoblastoma by Fluorescein Angiogram
Author Affiliations & Notes
  • A. Murphree
    Division of Ophthalmology, Childrens Hospital Los Angeles, Los Angeles, CA
  • R. Margolis
    Weill College of Medicine, Cornell University, New York, NY
  • M. Evans
    Ocular Pathology, Doheny Eye Institute, University of Southern California, Los Angeles, CA
  • N. Rao
    Ocular Pathology, Doheny Eye Institute, University of Southern California, Los Angeles, CA
  • Footnotes
    Commercial Relationships  A. Murphree, Massie Research Laboratories I, C, P; R. Margolis, None; M. Evans, None; N. Rao, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 4634. doi:
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      A. Murphree, R. Margolis, M. Evans, N. Rao; Diagnosis of Iris Neovascularization in Retinoblastoma by Fluorescein Angiogram . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4634.

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

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Abstract: : Purpose: To report our experience with fluorescein iris angiography in normal and retinoblastoma eyes, to confirm our angiographic data with histopathologic results and to describe a simple classification of iris neovascularization that may be of help in staging and assessing treatment response in eyes with retinoblastoma. Methods: Thirty–two patients with retinoblastoma had fluorescein angiograms of both healthy and tumor eyes as part of their initial staging examination. Fundus as well as anterior segment images were taken with the RetCam 120 from Massie Research Laboratories. Angiograms were graded for presence of NVI according to published systems, as well as our system (1=no NVI, 2=some NVI, 3=extensive NVI). Representative specimens were stained with hematoxylin and eosin (H+E) and by CD34 immunostaining to detect endothelial cells. Clinico–pathologic correlations were analyzed. Results: The sensitivity and specificity of the angiogram in detecting histologic NVI was 83.3% and 64.3%, respectively. The positive and negative predictive values were 66.7% and 81.8%, respectively. Radial vessels are clearly visible in normal blue irides but are not present in brown irides. Conclusions: Simultaneous iris and fundus angiograms are possible using the RetCam 120 in children during examinations under anesthesia. In healthy eyes, we observed a significant difference between brown and blue irides that must be taken into account when assessing the extent of iris neovascularization. We tested the capability of fluorescein angiography to accurately detect NVI in retinoblastoma containing eyes, and found a moderate and significant correlation between angiographic and histopathologic NVI. In comparison to those in the literature, our grading system for NVI had a comparable correlation but was easier to use and more consistently intrepreted by different cliniciams. The iris angiogram is an effective tool in evaluating NVI and may be useful both clinically and in animal models.

Keywords: retinoblastoma • neovascularization • iris 

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