July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Optical coherence tomography guided precision management strategies for retinoblastoma
Author Affiliations & Notes
  • Sameh Gaballah
    Ophthalmology, Hospital for Sick Children, University of Toronto, North York, Ontario, Canada
  • Cynthia Vandenhoven
    Ophthalmology, Hospital for Sick Children, University of Toronto, North York, Ontario, Canada
  • Leslie Mackeen
    Ophthalmology, Hospital for Sick Children, University of Toronto, North York, Ontario, Canada
  • Brenda L Gallie
    Ophthalmology, Hospital for Sick Children, University of Toronto, North York, Ontario, Canada
  • Footnotes
    Commercial Relationships   Sameh Gaballah, None; Cynthia Vandenhoven, None; Leslie Mackeen, None; Brenda Gallie, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1323. doi:
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    • Get Citation

      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.

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

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Abstract

Purpose : 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.

Methods : 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.

Results : 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.

Conclusions : 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.

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