Purchase this article with an account.
Sameh Gaballah, Cynthia Vandenhoven, Leslie Mackeen, Brenda L Gallie; Optical coherence tomography guided precision management strategies for retinoblastoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1323.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Optical coherence tomography (OCT) has revolutionized retinal and choroidal assessment. In retinoblastoma, OCT was reported to detect fovea-tumor relation, diagnose invisible tumors and subtle recurrences and suspect tumor invasion into the optic nerve head. We hypothesized that strategic incorporation of OCT into retinoblastoma management will improve outcomes.
We conducted a retrospective review of all eyes with retinoblastoma that had an OCT guided procedure whether diagnostic or therapeutic. To generate an OCT-guided strategy OCT software embedded tools (scan cube size and direction, multiple scan frames, localizing and measuring vertical and horizontal calipers, enhanced depth imaging frames and/or red free fundus photograph) were projected on the separate colored fundus image to guide management to improve visual, life and eye salvage outcomes.
We used OCT-guided strategies in 83 children (114 eyes). Diagnostic strategies included posterior pole screening for invisible retinoblastoma (37 eyes), topographic localization of invisible tumors (15 eyes) or subclinical recurrence (29 tumors), topographic localization of fovea-tumor relation (31 eyes) and mapping of potential choroidal or optic nerve invasion to determine subsequent management (2 eyes each). Therapeutic strategies included laser photocoagulation for perifoveal (26) and invisible (11) tumors, verification of photocoagulation adequacy for invisible (11) new and recurrent (11) tumors. These procedures were documented as reproducible strategies.
OCT improves retinoblastoma management and enables precision treatment by subclinical tumor management to maximize visual potential, reducing tumor scar size, avoiding unnecessary treatments, and anticipating potential tumor spread from large refractory tumors.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
This PDF is available to Subscribers Only