Optical coherence tomography (OCT) to image active and inactive retinoblastomas as well as retinomas

Abstract

Purpose To illustrate Optical Coherence Tomography (OCT) images of active and inactive retinoblastoma (Rb) tumours. Methods Current observational study included patients diagnosed with retinoblastoma and retinoma who were presented at Amsterdam UMC and Jules‐Gonin Eye Hospital, between November 2010 and October 2017. Patients aged between 0 and 4 years were imaged under general anaesthesia with handheld OCT in supine position. Patients older than 4 years were imaged with the conventional OCT (Heidelberg Engineering, Heidelberg Spectralis, Germany). All patients included were divided into two groups: active and inactive tumours (retinoma and regression patterns). Patients’ medical records and OCT images were analysed during meetings via discussions by ophthalmologists and physicists. Results Twelve Dutch and 8 Swiss patients were divided into two groups: 2 patients with active tumour versus 18 patients with inactive tumour. Subsequently, inactive group could be divided in two groups, which consisted of 10 patients with retinoma and 8 patients with different regression pattern types. Of all included patients, 15 were male (75%). Median age at diagnosis was 18.0 months (range 0.19–715.2 months). A total of 12 retinoblastoma (active and inactive) and 8 retinoma foci were investigated by OCT. No distinction could be made between active and inactive tumours using only OCT. Conclusion Optical coherence tomography alone cannot distinguish between active and inactive Rbs. However, handheld OCT adds useful information to the established imaging techniques in the monitoring and follow‐up of retinoblastoma patients. With this study, we provide an overview of OCT images of active and inactive Rbs.

A White Retinal Lesion With Calcification in an 11-Year-Old Boy

“…In this sense, optical coherence tomography can be helpful to noninvasively outline the intraretinal origin of retinoma/ retinoblastoma instead of the superficial retina, as seen in hamartomas. [7][8][9] B-scan ultrasonography, on the other hand, can highlight tumor calcification and provide consistent size documentation over time. Tumor biopsy (choice B) is not recommended for retinoma diagnostic confirmation owing to potential complications, including tumor seeding in case of masked retinoblastoma.…”

“…No treatment has so far been demonstrated effective in retinoma unless changes occur indicating conversion into retinoblastoma, as revealed by increasing retinal exudation, growth in size, seeds enlargement, or evolving vascularization. 3,8…”

Widefield Optical Coherence Tomography in Pediatric Retina: A Case Series of Intraoperative Applications Using a Prototype Handheld Device

“…Fundus photos are used to document these findings. Commercially available OCT systems are also widely used in retinoblastoma care, but have significant limitations due to their narrow field of view and narrow depth of focus (23)(24)(25)(26). Retinoblastoma tumors are often highly elevated, multifocal and arise in the peripheral retina as well as the posterior pole.…”

“…In retinoblastoma (RB), the most common primary intraocular malignancy in children, the value of OCT has been demonstrated, however, there are known challenges with commercially available OCT systems (23)(24)(25)(26). The potential value for WF-OCT to image and document tumor location and size, to monitor treatment response to laser, cryotherapy and chemotherapy, and to evaluate for newly emerging tumors is clear.…”

The Development and Clinical Application of Innovative Optical Ophthalmic Imaging Techniques

“…The HH-OCT is widely used nowadays for pediatric ocular conditions. HH-OCT/OCT-A systems can reliably visualize and measure vitreous opacities and bands, perifoveal vessels, the macular shape, anterior chamber features, retinal tumors, and ganglion cell complex (GCC)/IPL/RNFL thickness in both premature and full-term infants (120)(121)(122)(123)(124)(125)(126)(127)(128)(129)(130). Hence, they are useful in conditions, such as congenital and pediatric glaucoma, macular edema, macular hole, epiretinal membrane, retinoschisis, retinal dystrophies, and other conditions (128,129,(131)(132)(133).…”